Ferry County Public Hospital District No 1
Organization Active NPI Rural Health Clinic/Center · Republic, WA
NPI 1184776916 · NPPES record last updated Jul 21, 2025
Key facts
- NPI
- 1184776916
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- FERRY COUNTY PUBLIC HOSPITAL DISTRICT NO 1
- Practice address
- 10 Ros Circle
Republic, WA 99166-9701 - Phone
- (509) 775-3153
- Fax
- (509) 775-8929
- NPI assigned
- Jan 18, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Brian Lady
- Title
- Ceo
- Phone
- (509) 775-3333
Owners & managing parties with NPI records 3
Owned or controlled facilities with NPI records 3
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 3
Related certifications (CCN) 1
Facilities with the same owner 3
Practitioners 39
-
Eric Aronsohn, PA-C
-
Samuel A Artzis, MD
-
Robert T Brown, PAC
-
Annette L. Byrd, FNP-PP
-
Mari S Hunter, APN-C
-
Matthew Ryan Johnson, ARNP, RN
-
James Ivan Maeda, M.D.
-
Melissa Mitchell, DNP, AGPCNP-BC
-
Joseph D Petersen, ARNP
-
Patricia Ann Short, M.D.
-
Devon Woodley, DNP, ARNP
-
Kal Kelley, MD
-
Richard Garcia, D.O.
-
Laura Jean Karg, LCSW
-
Kristine M Carlson, MS, RD, LDN
-
Craig Christopher, PA-C
-
Violet L Eberly, PT, DPT
-
Amanda Jo Grumbach, DPT
-
CHI Yol Pak, P.T.
-
Kyle Rattray, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D1003649 | Republic Medical Clinic | Provider-performed microscopy | Apr 4, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WA
Rural health clinic certification: CCN 508522
- Legal name
- FERRY COUNTY PUBLIC HOSPITAL DISTRICT NO 1
- Doing business as
- REPUBLIC MEDICAL CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Sep 3, 2002
- Last certification
- Jun 9, 2015
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Enrollment address
- 10 Ros Cir
Republic, WA 99166-5002 - Related CCNs
- 501322
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Nancy Giddings |
Operational/Managerial Control |
Sep 3, 2014 | |
| Ferry County Public Hospital District No 1 |
Operational/Managerial Control | Jan 25, 2007 | |
| Aaron C Edwards |
W-2 Managing Employee |
Apr 1, 2017 | |
| Dianne Lundgren |
Operational/Managerial Control |
Jun 23, 2011 | |
| Julia Rae Santana |
W-2 Managing Employee | Oct 7, 2020 | |
| Ronald Brant Truman |
W-2 Managing Employee |
Jan 1, 2018 | |
| Jody L Jannot |
Operational/Managerial Control |
Sep 24, 2019 | |
| Sarah Krausse |
Operational/Managerial Control |
Jan 24, 2017 | |
| Ronald Bacon |
Operational/Managerial Control |
Nov 20, 2008 |
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Ferry County Memorial Hospital |
Hospital | Operational/Managerial Control | Nov 20, 2007 |
| Ferry County Memorial Hospital |
Hospital | Operational/Managerial Control | Nov 20, 2007 |
| Curlew Medical Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1989 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040309000167 | WA | Part B Supplier - Clinic/Group Practice | 0446148761 |
Receives reassigned benefits from 32 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Republic, WA |
| O20070920000639 | WA | Part a Provider - Rural Health Clinic | 0446148761 | Practice locations: Republic, WA |
National Provider Directory
Locations
10 Ros Cir
Republic, WA 99166
Phone (509) 775-3153
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
10 Ros Circle
Republic, WA 99166-9701
Mailing address
36 Klondike Rd
Republic, WA 99166-9701
Phone (509) 775-3153
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7113970 | Medicaid | WA | |
| 7033210 | Medicaid | WA |
Other names
- Republic Medical Clinic
Other providers in Republic, WA
- Ferry County Counseling Services
- Ferry County Counseling Services
- Ferry County Emergency Medical Services District 1
- Ferry County Hospital District #1
- Ferry County Public Hospital District
- Ferry County Public Hospital District No 1
- Ferry County Public Hospital District No 1
- Ferry County Sheriff
- Mailyn S Fleck
- Rachel S Flesher
All providers in Republic, WA · Rural Health Clinic/Center in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.