Individual provider Active NPI

Thatcher Thomas Harlan Felt

  • Pediatrics Physician
  • Grandview, WA
National Provider Identifier
1093713059
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OP00002003 Issued in WA
Practice address
1000 Wallace Way
Grandview, WA 98930-8805
Phone
(509) 882-3444
Fax
(509) 882-1097
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OP00002003 WA Primary

Addresses

Primary practice location

1000 Wallace Way
Grandview, WA 98930-8805

Mailing address

1000 Wallace Way
Grandview, WA 98930-8805
Phone (509) 882-3444

Other identifiers 3

IdentifierTypeStateIssuer
8437725MedicaidWA
911019392OtherCOMMERCIAL
8437725OtherWACHPW

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tfelt4827@yvfwc.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070212000087 WA Practitioner - Pediatric MedicinePractitioner - Osteopathic Manipulative Medicine 8325040900 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OP00002003WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Farm Workers Clinic Current Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Jan 14, 2016 Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Jan 14, 2016 Accepting new patients

Locations

1000 Wallace Way
Grandview, WA 98930
Phone (509) 788-1702

3801 Kern Rd
Yakima, WA 98902
Phone (509) 574-3200

Interoperability endpoints

  • Direct secure messaging: tfelt4827@yvfwc.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1093713059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WALLACE WAY",
            "city": "GRANDVIEW",
            "state": "WA",
            "postal_code": "989308805",
            "telephone_number": "509-882-3444",
            "fax_number": "509-882-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WALLACE WAY",
            "city": "GRANDVIEW",
            "state": "WA",
            "postal_code": "989308805",
            "telephone_number": "509-882-3444",
            "fax_number": "509-882-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELT",
        "first_name": "THATCHER",
        "middle_name": "THOMAS HARLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "OP00002003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8437725",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "911019392",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHPW",
            "identifier": "8437725",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfelt4827@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1000 Wallace Way",
            "city": "Grandview",
            "state": "WA",
            "country_code": "US",
            "postal_code": "989308805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grandview, WA

Sources for this page

Verify at the official NPI Registry.