NPIMap

Organization Active NPI

Providence Health & Services - Washington

Doing business as Providence Mount Carmel Hospital

  • Critical Access Hospital
  • Colville, WA
National Provider Identifier
1003067679
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Doing business as
Providence Mount Carmel Hospital
Practice address
982 E Columbia Ave
Colville, WA 99114-3316
Phone
(509) 684-2561
Fax
(509) 685-2492
NPI assigned
Oct 1, 2008
Last updated
May 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Donald Wayne Anderson Jr.
Title
Assistant Secreatry for Enrollment
Phone
(425) 358-9786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

982 E Columbia Ave
Colville, WA 99114-3316

Mailing address

PO Box 31001-4110
Pasadena, CA 91110-4110
Phone (509) 684-2561

Other names 1

  • Providence Mount Carmel Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081126000580 WA Part A Provider - Critical Access Hospital 3577623115 Receives reassigned benefits from 43 practitioners
Practice locations: Colville, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003067679. Details of each certification follow.

Hospital certification: CCN 501326

Legal name
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Doing business as
PROVIDENCE MOUNT CARMEL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jun 1, 2003
Last certification
Jul 12, 2007
Beds
25
Ownership / control type
Church
Most recent change of ownership
Jan 1, 2009 (2 total)
Organization structure
CorporationNon-profit
Incorporated
Jan 28, 1859 in WA
Enrollment address
982 E Columbia Ave
Colville, WA 99114-3316
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Providence Mount Carmel HospitalCCN 501326 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Providence Health Ser - Wa2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 25

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Diane L Hejna Individual Corporate Director Jul 1, 2016
Richard S Blair Individual Corporate Director Jul 1, 2016
Marvin O'Quinn Individual Corporate DirectorBoard of Directors Jan 1, 2024
Anthony Lawrence Individual W-2 Managing Employee Nov 29, 1993
Linda Buck Individual Corporate DirectorBoard Member Jan 1, 2025
Justin Voelker Individual W-2 Managing EmployeeFinancial Executive Jul 1, 2024
Providence Health & Services - Washington Organization, Renton, WA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2011 100%
Operational/Managerial Control Jan 1, 2011
Mary E Lyons Individual Corporate Director Jul 1, 2016
Phyllis M Hughes Individual Corporate Director Jan 1, 2014
Rogelio Riojas Individual Corporate DirectorBoard Member Jan 1, 2025
James Martin Individual Corporate OfficerAssistant Treasurer Jan 13, 2023
Charles Wallace Sorenson Individual Corporate DirectorBoard Member Jan 1, 2019
Donald Wayne Anderson Individual Corporate OfficerAssistant Secretary of Enrollments Jan 1, 2017
Gregory David Hoffman Individual Corporate OfficerCorporate Secretary Oct 1, 2020
Isiaah D Crawford Individual Corporate DirectorDirector Feb 1, 2012
Ronald G Rehn Individual W-2 Managing EmployeeChief Executive Jan 1, 2013
Donna Markham Individual Corporate DirectorBoard of Directors Jan 1, 2024
Michael W Murphy Individual Corporate DirectorBoard of Directors Jan 1, 2020
Providence Health & Services Organization, Renton, WA Corporation, Non-profit Operational/Managerial Control Jul 1, 2016 100%
Mary Beth Kingston Individual Corporate DirectorBoard of Directors Sep 1, 2022
Eric D Sprunk Individual Corporate Director Jan 1, 2022
Anna R Newsom Individual Corporate OfficerCorporate Secretary May 13, 2022
Darryl Elmouchi Individual Corporate OfficerPresident & Ceo Apr 1, 2025
Karin Dufault Individual Corporate DirectorBoard Member Jan 1, 2025
Providence St. Joseph Health Organization, Renton, WA Corporation, Non-profit Operational/Managerial Control Jul 1, 2016 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 141

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • CP King County Wa HH, LLC

    dba Providence at Home with Compassus Home Health, King

    • Home Health Agency
    • Tukwila, WA
    • NPI 1972325983

    Providence Health & Services, Providence Health & Services - Washington, Providence St. Joseph Health

    CMS ownership
  • CP Seattle Wa Hospice, LLC

    dba Providence at Home with Compassus Hospice Care, Puget Sound

    • Community Based Hospice Care Agency
    • Tukwila, WA
    • NPI 1174345193

    Providence Health & Services, Providence Health & Services - Washington, Providence St. Joseph Health

    CMS ownership
  • CP Snohomish County Wa, LLC

    dba Providence at Home with Compassus Home Health, Snohomish County

    • Community Based Hospice Care Agency
    • Everett, WA
    • NPI 1184446221

    Providence Health & Services, Providence Health & Services - Washington, Providence St. Joseph Health

    CMS ownership
  • CP Snohomish County Wa, LLC

    dba Providence at Home with Compassus Hospice Care, Snohomish County

    • Home Health Agency
    • Everett, WA
    • NPI 1720800857

    Providence Health & Services, Providence Health & Services - Washington, Providence St. Joseph Health

    CMS ownership
  • CP Sound Wa, LLC

    dba Providence at Home with Compassus Hospice Care, Puget Sound South

    • Community Based Hospice Care Agency
    • Lacey, WA
    • NPI 1659193795

    Providence Health & Services, Providence Health & Services - Washington, Providence St. Joseph Health

    CMS ownership
  • CP Sound Wa, LLC

    dba Providence at Home with Compassus Home Health, Puget Sound South

    • Home Health Agency
    • Lacey, WA
    • NPI 1669294708

    Providence Health & Services, Providence Health & Services - Washington, Providence St. Joseph Health

    CMS ownership
  • CP Spokane Wa HH, LLC

    dba Providence at Home with Compassus Home Health, INWA

    • Home Health Agency
    • Spokane Valley, WA
    • NPI 1033931043

    Providence Health & Services, Providence Health & Services - Washington, Providence St. Joseph Health

    CMS ownership
  • CP St. Mary Wa HH, LLC

    dba Providence at Home with Compassus Home Health, Walla Walla

    • Home Health Agency
    • Walla Walla, WA
    • NPI 1730901745

    Providence Health & Services, Providence Health & Services - Washington, Providence St. Joseph Health

    CMS ownership
  • Kadlec Regional Medical Center
    • General Acute Care Hospital
    • Richland, WA
    • NPI 1972507580

    Providence Health & Services - Washington

    CMS ownership
  • Northwest Washington Rehabilitation Hospital LLC

    dba Providence Swedish Rehabilitation Hospital

    • Rehabilitation Hospital
    • Lynnwood, WA
    • NPI 1306628821

    Providence Health & Services - Washington

    CMS ownership
  • Providence Health & Services - Wa

    dba Prov Scred Hrt Med Ctr & Chlds Hos

    • General Acute Care Hospital
    • Spokane, WA
    • NPI 1144471715

    Providence Health & Services, Providence Health & Services - Washington, Providence St. Joseph Health

    CMS ownership
  • Providence Health & Services - Wa

    dba Providence St Joseph Hospital

    • Medicare Defined Swing Bed Hospital Unit
    • Chewelah, WA
    • NPI 1447402839

    Providence Health & Services, Providence Health & Services - Washington, Providence St. Joseph Health

    CMS ownership
View all 141

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 45

Affiliated clinicians 303

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 303

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1003067679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-4110",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104110",
            "telephone_number": "509-684-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "982 E COLUMBIA AVE",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991143316",
            "telephone_number": "509-684-2561",
            "fax_number": "509-685-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES - WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-01",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECREATRY FOR ENROLLMENT",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Mount Carmel Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Mount Carmel Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colville, WA

Sources for this page

Verify at the official NPI Registry.