NPIMap

Organization Active NPI

Yakima Neighborhood Health Services

  • Federally Qualified Health Center (FQHC)
  • Granger, WA
National Provider Identifier
1134572548
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
YAKIMA NEIGHBORHOOD HEALTH SERVICES
Practice address
112 Main Street
Granger, WA 98932
Phone
(509) 383-6172
Fax
(509) 383-6173
NPI assigned
Jul 20, 2016
Last updated
Aug 30, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
YAKIMA NEIGHBORHOOD HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Authorized official

Name
Anita Monoian
Title
President/Ceo
Phone
(509) 454-4143

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

112 Main Street
Granger, WA 98932

Mailing address

PO Box 2605
Yakima, WA 98907-2605
Phone (509) 454-4143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161012002907 WA Part A Provider - Federally Qualified Health Center (FQHC) 6709786585 Practice locations: Granger, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1134572548. Details of each certification follow.

Federally qualified health center certification: CCN 941019

Legal name
YAKIMA NEIGHBORHOOD HEALTH SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 23, 2016
Last certification
Sep 23, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 6, 1979 in WA
Enrollment address
112 Main St
Granger, WA 98932-9306

Other NPIs with the same Medicare PAC ID 11

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

National Provider Directory

National Provider Directory
Tax ID family
Yakima Neighborhood Health22 organizations share this tax ID, including this one
Part of
Yakima Neighborhood Health

Other organizations with this tax ID 21

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

View all 21

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Mary K Kohlstadt-Huycke Individual Corporate Director May 21, 2003
Christina Newman Individual W-2 Managing EmployeeAd;Coo Jun 21, 2023
Rhonda Hauff Individual Corporate DirectorCeo Jan 1, 2022
Carol Holden Individual Corporate Director May 4, 2010
Gregory Nebeker Individual Corporate Director Oct 27, 2005
Edgar Hernandez Individual Corporate Director Apr 14, 2004
Don Hinman Individual Corporate Director May 6, 1980
Yolanda Garza Individual Corporate Director Sep 1, 2014
Nancy Kokenge Individual Corporate Director May 9, 1995

NPI Registry JSON

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1134572548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2605",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989072605",
            "telephone_number": "509-454-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MAIN STREET",
            "city": "GRANGER",
            "state": "WA",
            "postal_code": "98932",
            "telephone_number": "509-383-6172",
            "fax_number": "509-383-6173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAKIMA NEIGHBORHOOD HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YAKIMA NEIGHBORHOOD HEALTH SERVICES",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "MONOIAN",
        "authorized_official_first_name": "ANITA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "509-454-4143"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granger, WA

Sources for this page

Verify at the official NPI Registry.