Active NPI
Whidbey Island Public Hospital District
- Psychiatry Physician
- Byron Center, MI
National Provider Identifier
1134668205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- 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, 2021
- Organization subpart
- Yes
- Parent organization
- WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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.
-
- Psychiatry Physician
- Southfield, MI
- NPI 1700888179
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.