Tri-Cities Community Health

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

TRI-CITIES COMMUNITY HEALTH

Practice address

715 W Court St
Pasco, WA 99301-4153

Phone

(509) 547-2204

Fax

(509) 547-9329

NPI assigned

Sep 20, 2019

Last updated

Jan 11, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristy Needham

Title

Ceo

Phone

(509) 547-2204

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215588371. Details of each certification follow.

• CCN 941068 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 941068

Legal name

TRI-CITIES COMMUNITY HEALTH

Doing business as

MINNIE PESINA BUILDING

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Dec 27, 2019

Last certification

Dec 27, 2019

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

May 3, 2010 in WA

Enrollment address

715 W Court St
Pasco, WA 99301-4153

Other NPIs on the same Medicare enrollment 1

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

• Tri-Cities Community Health

  • Federally Qualified Health Center (FQHC)
  • Pasco, WA
  • NPI 1225145105

  O20200206001374

  Same enrollment

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.

Owners & managing parties with NPI records 1

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

• Amanda L Lang, O.D.

  • Optometrist
  • Ludington, MI
  • NPI 1295705846

  W-2 Managing Employee

  CMS ownership

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1215588371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1452",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993011223",
            "telephone_number": "509-547-2204",
            "fax_number": "509-547-9329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W COURT ST",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993014153",
            "telephone_number": "509-547-2204",
            "fax_number": "509-547-9329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITIES COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-20",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "NEEDHAM",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-547-2204"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tri Cities Foot & Ankle Clinic, PLLC (Tri Cities Foot & Ankle Clinic)
• Tri City Endodontics
• Tri-Cities Community Health (TCCH Pharmacy)
• Tri-Cities Community Health
• Tri-Cities Community Health
• Tri-Cities Community Health
• Tri-Cities Community Health
• Tri-Cities Community Health
• Tri-Cities Community Health (Benton Franklin County Detoxification Center)
• Tri-Cities Community Health

• Federally Qualified Health Center (FQHC) in Pasco, WA
• Providers in Pasco, WA by specialty
• Federally Qualified Health Center (FQHC) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.