Organization Active NPI

Whidbey Island Public Hospital District

  • Psychiatry Physician
  • Byron Center, MI
National Provider Identifier
1134668205
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Practice address
1378 Tufton Dr
Byron Center, MI 49315-6964
Phone
(360) 678-5151
Fax
(360) 678-7676
NPI assigned
Feb 21, 2017
Last updated
Jul 15, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
Ronald L Telles
Title
Ceo
Phone
(360) 678-7656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

1378 Tufton Dr
Byron Center, MI 49315-6964

Mailing address

PO Box 3603
Seattle, WA 98124-3603
Phone (360) 914-3110

Other practice location 1

4546 W Fox Farm Rd
Manistee, MI 49660-8505
Phone (360) 678-5151

Other practice location 2

30470 Leemoor St
Beverly Hills, MI 48025-4915
Phone (360) 678-5151

Other names 1

  • WhidbeyHealth Telehealth Other name

National Provider Directory

National Provider Directory
Part of
Whidbey Island Pub Hospital

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1134668205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3603",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243603",
            "telephone_number": "360-914-3110",
            "fax_number": "360-678-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1378 TUFTON DR",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493156964",
            "telephone_number": "360-678-5151",
            "fax_number": "360-678-7676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4546 W Fox Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Manistee",
            "state": "MI",
            "postal_code": "496608505",
            "country_code": "US",
            "telephone_number": "360-678-5151",
            "fax_number": "360-678-7676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30470 Leemoor St",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "MI",
            "postal_code": "480254915",
            "country_code": "US",
            "telephone_number": "360-678-5151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "enumeration_date": "2017-02-21",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "TELLES",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-678-7656"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WhidbeyHealth Telehealth",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "WhidbeyHealth Telehealth",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Byron Center, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.