NPIMap

Organization Active NPI

Public Hospital District No 2 Skagit County Washington

  • Rural Health Clinic/Center
  • Eastsound, WA
National Provider Identifier
1245827781
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON
Practice address
7 Deye LN
Eastsound, WA 98245-8578
Phone
(360) 376-2561
Fax
(360) 376-5183
NPI assigned
Dec 30, 2020
Last updated
Dec 30, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Authorized official

Name
Elise J Cutter
Title
Chief Operating Officer
Phone
(360) 299-1316

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

7 Deye LN
Eastsound, WA 98245-8578

Mailing address

1211 24TH St
Anacortes, WA 98221-2562
Phone (360) 299-1300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211014001162 WA Part A Provider - Rural Health Clinic 1153225198 Practice locations: Eastsound, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245827781. Details of each certification follow.

Rural health clinic certification: CCN 508595

Legal name
PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON
Doing business as
ISLAND PRIMARY CARE - ORCAS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 14, 2021
Last certification
Dec 14, 2021
Ownership / control type
2B
Organization structure
OtherNon-profit
Incorporated
Nov 19, 1958 in WA
Enrollment address
7 Deye LN
Eastsound, WA 98245-8578
Related CCNs
500007

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

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
John R Mathis MD5 organizations share this tax ID, including this one
Part of
John R Mathis MD

Other organizations with this tax ID 4

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

Locations

1004 M Ave
Anacortes, WA 98221
Phone (206) 299-1332

1211 24th St
Ste 2
Anacortes, WA 98221

1213 24th St
Ste 700
Anacortes, WA 98221
Phone (360) 293-5142

2601 M Ave
Ste B
Anacortes, WA 98221
Phone (360) 299-1302

2116 E Section St
Ph
Mount Vernon, WA 98274
Phone (360) 428-1700

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Public Hospital District No 2 Skagit County Washington Organization, Anacortes, WA Non-profit Operational/Managerial Control Dec 30, 2020 100%
Charles Hall Individual Corporate OfficerCeo Nov 11, 2019
W-2 Managing EmployeeCeo Nov 11, 2019
Operational/Managerial ControlCeo Nov 11, 2019
Elise J Cutter Individual Corporate OfficerCoo Dec 30, 2011
W-2 Managing EmployeeCoo Dec 30, 2011
Operational/Managerial ControlCoo Dec 30, 2011

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Island HospitalAnacortes, WA, CCN 500007 Hospital Operational/Managerial Control Jan 1, 2010
Anacortes Family MedicineAnacortes, WA, CCN 508505 Rural health clinic Operational/Managerial Control Feb 10, 2005
Fidalgo Medical AssociatesAnacortes, WA, CCN 508548 Rural health clinic Operational/Managerial Control Jan 1, 2010

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 135

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 135

NPI Registry JSON

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1245827781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 24TH ST",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212562",
            "telephone_number": "360-299-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 DEYE LN",
            "city": "EASTSOUND",
            "state": "WA",
            "postal_code": "982458578",
            "telephone_number": "360-376-2561",
            "fax_number": "360-376-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "CUTTER",
        "authorized_official_first_name": "ELISE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "360-299-1316"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastsound, WA

Sources for this page

Verify at the official NPI Registry.