NPIMap

Organization Active NPI

Lincoln County Hospital District 3

  • General Acute Care Hospital
  • Davenport, WA
National Provider Identifier
1013027218
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H-137 Issued in WA
Legal business name
LINCOLN COUNTY HOSPITAL DISTRICT 3
Practice address
10 Nicholls St
Davenport, WA 99122-9729
Phone
(509) 725-7101
Fax
(509) 725-2112
NPI assigned
Aug 30, 2006
Organization subpart
Yes
Parent organization
LINCOLN COUNTY HOSPITAL DISTRICT 3As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Authorized official

Name
Tyson E Lacy
Title
Ceo
Phone
(509) 725-2979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H-137 WA Primary

Addresses

Primary practice location

10 Nicholls St
Davenport, WA 99122-9729

Mailing address

10 Nicholls St
Davenport, WA 99122-9729
Phone (509) 725-7101

Other identifiers 4

IdentifierTypeStateIssuer
7117450MedicaidWA
4231708MedicaidWA
7101132MedicaidWA
CJ6525OtherWAMEDICARE RAILROAD

Other names 1

  • Lincoln Hospital Swing Bed Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040505000483 WA Part B Supplier - Clinic/Group Practice 3971591199 Receives reassigned benefits from 21 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Davenport, WA
O20080110000455 WA Part A Provider - Critical Access Hospital 3971591199 Practice locations: Davenport, WA

Hospital certification: CCN 50Z305

Legal name
LINCOLN COUNTY HOSPITAL DISTRICT 3
Organization structure
GovernmentNon-profit
Incorporated
Jan 1, 1962 in WA
Enrollment address
10 Nicholls St
Davenport, WA 99122-9729
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Herschell Smith Individual Corporate Director Oct 1, 2014
Rox a Sherwood Individual Corporate DirectorBoard Member Jun 5, 2006
Jennifer Larmer Individual Corporate OfficerChief Patient Services Officer Feb 1, 2011
Timothy R O'Connell Individual Corporate OfficerCfo Mar 1, 2016
Lincoln County Hospital District 3 Organization, Davenport, WA Operational/Managerial Control Jan 1, 1966 100%
Tyson Lacy Individual Corporate OfficerCfo/Coo Oct 22, 2008
Darci Linstrum Individual W-2 Managing EmployeeRevenue Cycle Director Jan 1, 2007

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lincoln County Hospital District 3Davenport, WA, CCN 501305 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 1966
North Basin Medical ClinicsDavenport, WA, CCN 508529 Rural health clinic Operational/Managerial Control Oct 23, 2007
North Basin Medical ClinicsReardan, WA, CCN 508528 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2002
North Basin Medical ClinicsWilbur, WA, CCN 508530 Rural health clinic Other (100%) Jun 15, 2006

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1013027218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 NICHOLLS ST",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991229729",
            "telephone_number": "509-725-7101",
            "fax_number": "509-725-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 NICHOLLS ST",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991229729",
            "telephone_number": "509-725-7101",
            "fax_number": "509-725-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN COUNTY HOSPITAL DISTRICT 3",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LINCOLN COUNTY HOSPITAL DISTRICT 3",
        "enumeration_date": "2006-08-30",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A",
        "authorized_official_last_name": "LACY",
        "authorized_official_first_name": "TYSON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-725-2979"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WA",
            "license": "H-137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7117450",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4231708",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101132",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CJ6525",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln Hospital Swing Bed",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Lincoln Hospital Swing Bed",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Davenport, WA

Sources for this page

Verify at the official NPI Registry.