NPIMap

Organization Active NPI

Okanogan County Public Hospital Dist No 4

  • Critical Access Hospital
  • Tonasket, WA
National Provider Identifier
1164580700
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
H-107 Issued in WA
Legal business name
OKANOGAN COUNTY PUBLIC HOSPITAL DIST NO 4
Practice address
203 S Western Ave
Tonasket, WA 98855-8803
Phone
(509) 486-2151
Fax
(509) 486-3116
NPI assigned
Dec 5, 2006
Last updated
Nov 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Authorized official

Name
Mr. John A McReynolds
Title
Cfo
Phone
(509) 486-3128

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X
Critical Access Hospital 282NC0060X H-107 WA Primary

Addresses

Primary practice location

203 S Western Ave
Tonasket, WA 98855-8803

Mailing address

203 S Western Ave
Tonasket, WA 98855-8803
Phone (509) 486-2151

Other identifiers 4

IdentifierTypeStateIssuer
030OtherBLUE CROSS
3318201MedicaidWA
13751OtherWAL & I
H-107OtherWAWASHINGTON STATE DOH LICENSE

Other names 1

  • NORTH VALLEY HOSPITAL Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040323000641 WA Part B Supplier - Clinic/Group Practice 9335051150 Receives reassigned benefits from 215 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tonasket, WA
O20061104000210 WA Part A Provider - Critical Access Hospital 9335051150 Receives reassigned benefits from 160 practitioners
Practice locations: Tonasket, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164580700. Details of each certification follow.

Hospital certification: CCN 501321

Legal name
OKANOGAN COUNTY PUBLIC HOSPITAL DIST NO 4
Doing business as
NORTH VALLEY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Nov 1, 2002
Last certification
Jul 30, 2021
Beds
85 (25 certified)
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Incorporated
Jan 1, 1972 in WA
Enrollment address
126 S Whitcomb Ave
Tonasket, WA 98855-8864
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
North Valley HospitalCCN 501321 · All quality measures
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
Okanogan Cnty PB Hosp D2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
John McReynolds Individual Operational/Managerial ControlCoo Jun 1, 2017
Dick Larson Individual Corporate Director Nov 26, 1985
Tegan Currie Individual Corporate OfficerHim Manager Sep 22, 2019
Adam Tibbs Individual Corporate DirectorBoard Member Jun 25, 2015 20%
Okanogan County Public Hospital Dist No 4 Organization, Tonasket, WA Operational/Managerial Control Jan 1, 1972

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
North Valley HospitalTonasket, WA, CCN 50Z321 Hospital Operational/Managerial Control Nov 11, 2010
Tonasket Family RHCTonasket, WA, CCN 508594 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 27, 2020

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 197

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 197

Affiliated clinicians 84

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

View all 84

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1164580700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S WESTERN AVE",
            "city": "TONASKET",
            "state": "WA",
            "postal_code": "988558803",
            "telephone_number": "509-486-2151",
            "fax_number": "509-486-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S WESTERN AVE",
            "city": "TONASKET",
            "state": "WA",
            "postal_code": "988558803",
            "telephone_number": "509-486-2151",
            "fax_number": "509-486-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKANOGAN COUNTY PUBLIC HOSPITAL DIST NO 4",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "MCREYNOLDS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "509-486-3128",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WA",
            "license": "H-107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "030",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3318201",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "13751",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DOH LICENSE",
            "identifier": "H-107",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTH VALLEY HOSPITAL",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "NORTH VALLEY HOSPITAL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tonasket, WA

Sources for this page

Verify at the official NPI Registry.