NPIMap

Organization Active NPI

Lifeline Connections

  • Community/Behavioral Health Agency
  • Bellingham, WA
National Provider Identifier
1144703836
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LIFELINE CONNECTIONS
Practice address
4120 Meridian St Ste 220
Bellingham, WA 98226-5575
Phone
(360) 922-3030
NPI assigned
Sep 10, 2018
Last updated
Mar 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Authorized official

Name
Kinh Reynolds
Title
Cfo
Phone
(360) 397-8246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

4120 Meridian St Ste 220
Bellingham, WA 98226-5575

Mailing address

PO Box 1678
Vancouver, WA 98668-1678
Phone (360) 397-8246

Other practice location 1

2015 Continental Pl
Suite A
Mt. Vernon, WA 98273-9827
Phone (360) 399-6900

Other identifiers 1

IdentifierTypeStateIssuer
1990126MedicaidWA

Other names 1

  • Lifeline Connections - Bellingham Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171115003724 WA Part B Supplier - Clinic/Group Practice 2860758307 Receives reassigned benefits from 10 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vancouver, WA; Bellingham, WA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lifeline Connections3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

4120 Meridian St
Ste 220
Bellingham, WA 98226
Phone (360) 922-3030

1413 E College Way
Mount Vernon, WA 98273
Phone (360) 397-8245

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/lifelineconnections/r4/

Practitioners & affiliated clinicians

Practitioners 62

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.

View all 62

NPI Registry JSON

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1144703836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1678",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986681678",
            "telephone_number": "360-397-8246",
            "fax_number": "360-397-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 MERIDIAN ST STE 220",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982265575",
            "telephone_number": "360-922-3030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2015 Continental Pl",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Mt. Vernon",
            "state": "WA",
            "postal_code": "982739827",
            "country_code": "US",
            "telephone_number": "360-399-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFELINE CONNECTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-10",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "KINH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "360-397-8246"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1990126",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifeline Connections - Bellingham",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Lifeline Connections - Bellingham",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.