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Chelan County Public Hospital District No. 2

Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Chelan, WA

NPI 1215040555 · NPPES record last updated Apr 25, 2023

Key facts

NPI
1215040555
Entity type
Organization (NPI type 2)
Primary specialty
Medicare Defined Swing Bed Hospital Unit 275N00000X
License
H-165 (WA)
Legal business name
CHELAN COUNTY PUBLIC HOSPITAL DISTRICT NO. 2
Practice address
110 S Apple Blossom Dr
Chelan, WA 98816-8810
Phone
(509) 682-3300
Fax
(509) 682-9614
NPI assigned
Aug 17, 2006
Organization subpart
No

Authorized official

Name
Aaron Christopher Edwards
Title
Ceo
Phone
(509) 683-3300

Owners & managing parties with NPI records 2

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

Owned or controlled facilities with NPI records 2

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

Other NPIs on the same Medicare enrollment 4

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

Other NPIs with the same Medicare PAC ID 2

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

Corporate family (same tax ID) 14

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

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

Facilities with the same owner 2

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

Practitioners 20

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

Affiliated clinicians 2

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in WA

Hospital certification: CCN 50Z334

Legal name
CHELAN COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Doing business as
LAKE CHELAN COMMUNITY HOSPITAL
Organization structure
Government · Non-profit
Incorporated
Aug 16, 1945 in WA
Enrollment address
110 S Apple Blossom Dr
Chelan, WA 98816-8810

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Victoria Bodle
Individual 		W-2 Managing Employee
Controller		 May 26, 2019
Aaron C Edwards
Individual 		W-2 Managing Employee
Ceo		 Apr 11, 2022
Mary Murphy
Individual 		W-2 Managing Employee
Director		 Jan 1, 2017
Ronald Brant Truman
Individual 		W-2 Managing Employee
Cfo		 Sep 1, 2022
Lorijean M Withrow
Individual 		Corporate Director Jan 1, 2022
Jordana Laporte
Individual 		Corporate Officer
Director		 May 31, 2018
Mary Signorelli
Individual 		Corporate Director Dec 1, 2014
Jeremy Jaech
Individual 		Corporate Director Apr 27, 2021
Chelan County Public Hospital District No 2
Organization · Chelan, WA 		Operational/Managerial Control Jun 6, 2009

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Lake Chelan Community Hospital
Chelan, WA · CCN 501334		 Hospital Operational/Managerial Control Jun 6, 2009
Express Care Lake Chelan Health
Chelan, WA · CCN 508567		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2014

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031226000201 WA Part B Supplier - Clinic/Group Practice 9133027360 Receives reassigned benefits from 160 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chelan, WA
O20070911000529 WA Part a Provider - Critical Access Hospital 9133027360 Receives reassigned benefits from 2 practitioners
Practice locations: Chelan, WA

National Provider Directory

Tax ID family
Lake Chelan Comm Hospit (15 organizations share this tax ID)

Locations

110 S Apple Blossom Dr
Chelan, WA 98816
Phone (509) 682-3300

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X H-165 WA Yes

Addresses

Primary practice location

110 S Apple Blossom Dr
Chelan, WA 98816-8810

Mailing address

PO Box 908
Chelan, WA 98816-0908
Phone (509) 682-3300

Other names

  • Lake Chelan Hospital Swing Bed Doing business as

Other providers in Chelan, WA

All providers in Chelan, WA · Medicare Defined Swing Bed Hospital Unit in Washington

Sources for this page

Verify at the official NPI Registry.