NPIMap

Organization Active NPI

Lake Roosevelt Community Health Centers

  • Family Medicine Physician
  • Inchelium, WA
National Provider Identifier
1073776936
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LAKE ROOSEVELT COMMUNITY HEALTH CENTERS
Practice address
39 Short Cut Road
Inchelium, WA 99138-0290
Phone
(509) 722-7610
NPI assigned
Jul 9, 2008
Last updated
Jul 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Authorized official

Name
Mr. Bill Foxcroft
Title
Executive Director
Phone
(509) 722-7610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

39 Short Cut Road
Inchelium, WA 99138-0290

Mailing address

39 Short Cut Road
PO Box 290
Inchelium, WA 99138-0290
Phone (509) 722-7610

Other names 1

  • Colville Nations Community Health Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Colville Nation Community4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1073776936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 SHORT CUT ROAD",
            "address_2": "PO BOX 290",
            "city": "INCHELIUM",
            "state": "WA",
            "postal_code": "991380290",
            "telephone_number": "509-722-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 SHORT CUT ROAD",
            "city": "INCHELIUM",
            "state": "WA",
            "postal_code": "991380290",
            "telephone_number": "509-722-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ROOSEVELT COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "FOXCROFT",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "509-722-7610",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colville Nations Community Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Inchelium, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.