Warm Beach Health Care Center Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

645 Issued in WA

Legal business name

WARM BEACH HEALTH CARE CENTER INC.

Practice address

20420 Marine Dr
Stanwood, WA 98292-6116

Phone

(360) 652-2608

Fax

(360) 652-2622

NPI assigned

Oct 6, 2005

Last updated

Oct 19, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Hovey

Title

Healthcare Administrator

Phone

(360) 652-2600

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073501847. Details of each certification follow.

• CCN 505405 Skilled nursing facility · Terminated · Details

Skilled nursing facility certification: CCN 505405

Legal name

WARM BEACH HEALTHCARE CENTER

Doing business as

WARM BEACH HEALTHCARE CENTER

Certification status

Terminated Voluntary: other reason for withdrawal, Nov 1, 2022

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1992

Last certification

Oct 3, 2019

Beds

59

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Oct 5, 1975 in WA

Enrollment address

20420 Marine Drive
Stanwood, WA 98292

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 15

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

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666137600000",
    "number": "1073501847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20420 MARINE DR",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982926116",
            "telephone_number": "360-652-2608",
            "fax_number": "360-652-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20420 MARINE DR",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982926116",
            "telephone_number": "360-652-2608",
            "fax_number": "360-652-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARM BEACH HEALTH CARE CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A",
        "authorized_official_last_name": "HOVEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "HEALTHCARE ADMINISTRATOR",
        "authorized_official_telephone_number": "360-652-2600"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4164505",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Stanwood, WA
• Providers in Stanwood, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.