NPIMap

Public Hospital District No 1 of Mason County

Organization Active NPI Clinic/Center · Shelton, WA

NPI 1306275409 · NPPES record last updated Nov 8, 2013

Key facts

NPI
1306275409
Entity type
Organization (NPI type 2)
Primary specialty
Clinic/Center 261Q00000X
Legal business name
PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY
Practice address
221 Professional Way
Shelton, WA 98584-4404
Phone
(360) 426-2500
NPI assigned
Nov 8, 2013
Organization subpart
No

Authorized official

Name
Mr. Eric Moll
Title
Chief Executive Officer
Phone
(360) 427-9554

Other NPIs on the same Medicare enrollment 10

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

Corporate family (same tax ID) 17

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

Practitioners 6

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040310001481 WA Part B Supplier - Clinic/Group Practice 0345139275 Receives reassigned benefits from 180 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Shelton, WA; Olympia, WA; Hoodsport, WA

National Provider Directory

Tax ID family
Public Hospital District No (18 organizations share this tax ID)

Locations

901 Mountain View Dr
Shelton, WA 98584
Phone (360) 426-1611

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Yes

Addresses

Primary practice location

221 Professional Way
Shelton, WA 98584-4404

Mailing address

221 Professional Way
Shelton, WA 98584-4404
Phone (360) 426-2500

Other names

  • Mason General Hospital Olympic Physicians Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 8, 2013.

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383868800000",
    "number": "1306275409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 PROFESSIONAL WAY",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844404",
            "telephone_number": "360-426-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 PROFESSIONAL WAY",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844404",
            "telephone_number": "360-426-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A",
        "authorized_official_last_name": "MOLL",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "360-427-9554",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mason General Hospital Olympic Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelton, WA

All providers in Shelton, WA · Clinic/Center in Washington

Sources for this page

Verify at the official NPI Registry.