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Organization Active NPI

Grays Harbor Community Hospital

  • General Acute Care Hospital
  • Aberdeen, WA
National Provider Identifier
1154378859
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
282N00000X Issued in WA
Legal business name
GRAYS HARBOR COMMUNITY HOSPITAL
Practice address
915 Anderson Dr
Aberdeen, WA 98520-1006
Phone
(360) 537-6116
Fax
(360) 537-6100
NPI assigned
May 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Authorized official

Name
Tim Howden
Title
Cfo
Phone
(360) 537-6116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 282N00000X WA Primary

Addresses

Primary practice location

915 Anderson Dr
Aberdeen, WA 98520-1006

Mailing address

1006 N H St
Aberdeen, WA 98520-2535
Phone (360) 537-6116

Other identifiers 1

IdentifierTypeStateIssuer
3307907MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031231000081 WA Part B Supplier - Clinic/Group Practice 3577462365 Receives reassigned benefits from 213 practitioners
11 other NPIs on this enrollment
Practice locations: Aberdeen, WA; Hoquiam, WA; Montesano, WA; Westport, WA
O20041117000369 WA Part A Provider - Hospital 3577462365 Practice locations: Aberdeen, WA

Hospital certification: CCN 500031

Legal name
GRAYS HARBOR COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 20, 2007
Beds
70
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1966 in WA
Enrollment address
915 Anderson Dr
Aberdeen, WA 98520-1006
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 11

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Grays Harbor Community HospitalCCN 500031
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1006 N H St
#3
Aberdeen, WA 98520

939 Anderson Dr
Aberdeen, WA 98520

1006 N H St
Fl 44
Aberdeen, WA 98520

1006 N H St
Aberdeen, WA 98520
Phone (360) 537-6032

575 E Main St
Unit A
Elma, WA 98541

819 K St
Hoquiam, WA 98550

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Thomas Jensen Individual Corporate OfficerCeo Sep 7, 2010
Operational/Managerial ControlCeo Sep 7, 2010 100%
Grays Harbor Community Hospital Organization, Aberdeen, WA Corporation 5% Or Greater Direct Ownership Interest Jan 1, 2007 100%
Operational/Managerial Control Jan 14, 2014
Jonathan S Dilley Individual Corporate DirectorCommisioner Jan 1, 2019
Lynn Csernotta Individual Corporate DirectorCommisioner Jan 1, 2019
David Quigg Individual Corporate DirectorCommisioner Jan 1, 2018
Christopher Thomas Individual Corporate DirectorCommisioner Jan 1, 2018
Niall Shea Foley Individual Corporate OfficerChief Financial Officer Nov 16, 2018
W-2 Managing EmployeeExecutive Director of Finance Sep 17, 2017
Andrew J Bickar Individual Corporate Director Jan 1, 2015

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Hoquiam ClinicHoquiam, WA, CCN 508577 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 16, 2018
GHCH Aberdeen East ClinicAberdeen, WA, CCN 508576 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 16, 2018
GHCH Montesano ClinicMontesano, WA, CCN 508575 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 16, 2018

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 231

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 231

Affiliated clinicians 289

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 289

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1154378859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 N H ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985202535",
            "telephone_number": "360-537-6116",
            "fax_number": "360-537-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 ANDERSON DR",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985201006",
            "telephone_number": "360-537-6116",
            "fax_number": "360-537-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAYS HARBOR COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "HOWDEN",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "360-537-6116"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WA",
            "license": "282N00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3307907",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

Verify at the official NPI Registry.