NPIMap

Organization Active NPI

Tri-Cities Digestive Health Center, PS

  • Endoscopy Clinic/Center
  • Kennewick, WA
National Provider Identifier
1003987868
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
Legal business name
TRI-CITIES DIGESTIVE HEALTH CENTER, PS
Practice address
8819 W Victoria Ave
Kennewick, WA 99336
Phone
(509) 460-5500
Fax
(509) 460-5111
NPI assigned
Nov 13, 2006
Last updated
Nov 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Authorized official

Name
Mrs. Chayanin Boonpongmanee
Title
Administrator
Phone
(509) 460-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endoscopy Clinic/Center 261QE0800X NU Primary

Addresses

Primary practice location

8819 W Victoria Ave
Kennewick, WA 99336

Mailing address

8819 W Victoria Ave
Kennewick, WA 99336
Phone (509) 460-5500

Other identifiers 1

IdentifierTypeStateIssuer
7109432MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040802000335 WA Part B Supplier - Clinic/Group Practice 1759278633 Receives reassigned benefits from 17 practitioners
Practice locations: Kennewick, WA

National Provider Directory

National Provider Directory

Locations

780 Swift Blvd
Ste 280
Richland, WA 99352
Phone (509) 946-9425

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1003987868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8819 W VICTORIA AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "99336",
            "telephone_number": "509-460-5500",
            "fax_number": "509-460-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8819 W VICTORIA AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "99336",
            "telephone_number": "509-460-5500",
            "fax_number": "509-460-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITIES DIGESTIVE HEALTH CENTER, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "BOONPONGMANEE",
        "authorized_official_first_name": "CHAYANIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "509-460-5500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7109432",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.