NPIMap

Organization Active NPI

Whidbey Island Public Hospital District

  • Critical Access Hospital
  • Coupeville, WA
National Provider Identifier
1164549549
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
000092 Issued in WA
Legal business name
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Practice address
101 N Main St
Coupeville, WA 98239-3413
Phone
(360) 678-5151
NPI assigned
Mar 23, 2007
Last updated
Jul 20, 2023By 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 20, 2023

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

Authorized official

Name
Garth A MillerNPI 1801082102
Title
Coo
Phone
(360) 678-7656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 000092 WA Primary

Addresses

Primary practice location

101 N Main St
Coupeville, WA 98239-3413

Mailing address

PO Box 3603
Seattle, WA 98124-3603
Phone (360) 678-7656

Other identifiers 1

IdentifierTypeStateIssuer
15X01OtherWAEMS LICENSE

Other names 1

  • WhidbeyHealth Ambulance Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071105000513 WA Part A Provider - Critical Access Hospital 1658280680 Receives reassigned benefits from 55 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clinton, WA; Coupeville, WA; Oak Harbor, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164549549. Details of each certification follow.

Hospital certification: CCN 501339

Legal name
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Doing business as
WHIDBEYHEALTH MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 31, 2005
Last certification
Jul 22, 2020
Beds
51
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Enrollment address
101 N Main St
Coupeville, WA 98239-3413
Main/Primary Hospital Location

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

Other NPIs on the same Medicare enrollment 5

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Whidbeyhealth Medical CenterCCN 501339 · All quality measures
Overall star rating
2 of 5
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Whidbey Island Pub Hospital38 organizations share this tax ID, including this one
Part of
Whidbey Island Pub Hospital

Other organizations with this tax ID 37

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

View all 37

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Whidbey Island Public Hospital District Organization, Coupeville, WA 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Curtis Andrew Shumate Individual Corporate DirectorExecutive Director of Nursing Feb 1, 2022
W-2 Managing Employee Feb 22, 2010
Kirk P Gasper Individual Corporate OfficerCommissioner Dec 2, 2025
Corporate DirectorCommissioner Dec 2, 2025
Garth a Miller Individual Corporate OfficerChief Operations Officer Sep 23, 2021
Corporate DirectorChief Operations Officer Sep 23, 2021
W-2 Managing Employee Aug 1, 2018
James Dean Golder Individual Corporate Officer Jan 1, 2022
Corporate Director Jan 1, 2022
Mark Ethan Borden Individual Corporate OfficerCommissioner Jan 1, 2026
Corporate DirectorCommissioner Jan 1, 2026
Marion Louise Jouas Individual Corporate DirectorCommissioner Dec 14, 2023
Jamie Canby Individual Corporate OfficerCommissioner Jan 1, 2026
Corporate DirectorCommissioner Jan 1, 2026
Paul Rogers Individual Corporate OfficerInterim Cfo Sep 16, 2022
Corporate DirectorInterim Cfo Sep 16, 2022
Nathan Staggs Individual Corporate OfficerCeo Mar 22, 2023
Corporate DirectorCeo Mar 22, 2023
W-2 Managing EmployeeCeo Mar 22, 2023

Owners & managing parties with NPI records 13

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

View all 13

Practitioners & affiliated clinicians

Practitioners 3

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.

Affiliated clinicians 336

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

View all 336

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1164549549",
    "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": "360-678-7656",
            "fax_number": "360-678-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N MAIN ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982393413",
            "telephone_number": "360-678-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "enumeration_date": "2007-03-23",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GARTH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "360-678-7656"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WA",
            "license": "000092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMS LICENSE",
            "identifier": "15X01",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WhidbeyHealth Ambulance",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "WhidbeyHealth Ambulance",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Coupeville, WA

Sources for this page

Verify at the official NPI Registry.