NPIMap

Organization Active NPI

Whidbey Island Manor, Inc.

  • Skilled Nursing Facility
  • Oak Harbor, WA
National Provider Identifier
1063591998
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
4148102 Issued in WA
Legal business name
WHIDBEY ISLAND MANOR, INC.
Practice address
235 SW 6TH Ave
Oak Harbor, WA 98277-1900
Phone
(360) 675-5913
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mark S. Wiggins
Title
Administrator/Ceo
Phone
(360) 675-5913

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 4148102 WA Primary

Addresses

Primary practice location

235 SW 6TH Ave
Oak Harbor, WA 98277-1900

Mailing address

PO Box 1900
Oak Harbor, WA 98277-1900
Phone (360) 675-5913

Other identifiers 1

IdentifierTypeStateIssuer
4148102MedicaidWA

Other names 1

  • Whidbey Island Manor Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063591998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1900",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982771900",
            "telephone_number": "360-675-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 SW 6TH AVE",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982771900",
            "telephone_number": "360-675-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHIDBEY ISLAND MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WIGGINS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "360-675-5913"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "4148102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4148102",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Whidbey Island Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.