NPIMap

Organization Active NPI

Skagit Hospice Services L L C

Doing business as Hospice of the Northwest

  • Community Based Hospice Care Agency
  • Mount Vernon, WA
National Provider Identifier
1174693139
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
IS-437 Issued in WA
Legal business name
SKAGIT HOSPICE SERVICES L L C
Doing business as
Hospice of the Northwest
Practice address
227 Freeway Dr
Suite a
Mount Vernon, WA 98273-2805
Phone
(360) 814-5550
Fax
(360) 814-5591
NPI assigned
Nov 8, 2006
Last updated
Nov 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Authorized official

Name
Robert Laws
Title
Executive Director
Phone
(360) 814-5550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X IS-437 WA Primary

Addresses

Primary practice location

227 Freeway Dr
Suite a
Mount Vernon, WA 98273-2805

Mailing address

227 Freeway Dr Ste a
Mount Vernon, WA 98273-2887
Phone (360) 814-5550

Other identifiers 1

IdentifierTypeStateIssuer
3990090MedicaidWA

Other names 1

  • Hospice of the Northwest Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000730 WA Part A Provider - Hospice 0042115230 Practice locations: Mount Vernon, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174693139. Details of each certification follow.

Hospice certification: CCN 501505

Legal name
SKAGIT HOSPICE SERVICES L L C
Doing business as
HOSPICE OF THE NORTHWEST
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 15, 1984
Last certification
Aug 14, 2013
Ownership / control type
Combination Government and Nonprofit
Organization structure
LLCProprietary
Incorporated
Jan 1, 2004 in WA
Enrollment address
227 Freeway Dr
Ste a
Mount Vernon, WA 98273-2887

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice of the NorthwestCCN 501505 · All quality measures
Ownership
Combination Government & Non-Profit
Certified
Mar 15, 1984
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2121120Hospice of the Northwest227 Freeway Dr Ste a, Mount Vernon, WA 98273Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

227 Freeway Dr
Ste A
Mount Vernon, WA 98273
Phone (360) 814-5550

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Jonathan Lyons Individual Corporate DirectorOperating Council Member May 1, 2018
Robert G Laws Individual Corporate Director Aug 24, 2016
W-2 Managing EmployeeAd; Aug 24, 2016
Erika R B Pope Individual Corporate DirectorMedical Director Jan 1, 2024
W-2 Managing Employee Jan 1, 2024
Public Hospital Dist No 1 Skagit Organization, Mount Vernon, WA 5% Or Greater Direct Ownership Interest Apr 1, 2007 50%
Operational/Managerial Control Apr 1, 2007 50%
Skagit County Public Hospital District No 304 Organization, Sedro Woolley, WA 5% Or Greater Direct Ownership Interest Apr 1, 2007 50%
Carol Hawk Individual Corporate DirectorOperating Council Member Jan 1, 2015
Ted Brockman Individual Corporate DirectorPresident Jan 1, 2015

Owners & managing parties with NPI records 7

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 7

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 52

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

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1174693139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 FREEWAY DR STE A",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732887",
            "telephone_number": "360-814-5550",
            "fax_number": "360-814-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 FREEWAY DR",
            "address_2": "SUITE A",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732805",
            "telephone_number": "360-814-5550",
            "fax_number": "360-814-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKAGIT HOSPICE SERVICES L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "LAWS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-814-5550"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WA",
            "license": "IS-437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3990090",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospice of the Northwest",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hospice of the Northwest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.