NPIMap

Organization Active NPI

Prosser Public Hospital District of Benton County

Doing business as Prosser Memorial Health

  • Critical Access Hospital
  • Prosser, WA
National Provider Identifier
1306897681
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
HAC.FS.00000046 Issued in WA
Legal business name
PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY
Doing business as
Prosser Memorial Health
Practice address
200 Prosser Health Dr
Prosser, WA 99350-7832
Phone
(509) 786-2222
Fax
(509) 788-6013
NPI assigned
May 12, 2006
Last updated
Feb 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Authorized official

Name
Craig Marks
Title
Ceo
Phone
(509) 786-2222

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital Clinic/Center 261QC0050X 000056 WA
Critical Access Hospital 282NC0060X 000056 WA
Critical Access Hospital 282NC0060X HAC.FS.00000046 WA Primary

Addresses

Primary practice location

200 Prosser Health Dr
Prosser, WA 99350-7832

Mailing address

PO Box 84112
Seattle, WA 98124-5412
Phone (509) 786-2222

Other identifiers 7

IdentifierTypeStateIssuer
001944OtherWAPMH L & I
0082383OtherWAL & I PROF/SERV
7118334MedicaidWA
7888803MedicaidWA
7064801MedicaidWA
3303807MedicaidWA
9048463MedicaidWA

Other names 1

  • Prosser Memorial Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040120000974 WA Part B Supplier - Clinic/Group Practice 6709787872 Receives reassigned benefits from 248 practitioners
8 other NPIs on this enrollment
Practice locations: Walla Walla, WA; Prosser, WA; Grandview, WA; Benton City, WA
O20060317000302 WA Part A Provider - Critical Access Hospital 6709787872 Receives reassigned benefits from 62 practitioners
Practice locations: Prosser, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306897681. Details of each certification follow.

Hospital certification: CCN 501312

Legal name
PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY
Doing business as
PROSSER MEMORIAL HEALTH
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 1, 2002
Last certification
Jun 18, 2021
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Incorporated
Dec 26, 1947 in WA
Enrollment address
200 Prosser Health Dr
Prosser, WA 99350-7832
Other Hospital Practice Location

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).

Other NPIs on the same Medicare enrollment 8

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Prosser Memorial HospitalCCN 501312 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2314886Prosser Memorial Health200 Prosser Health Dr, Prosser, WA 99350ComplianceApr 4, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1003 Wallace Way
Grandview, WA 98930
Phone (509) 203-1080

Networks

  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

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.

NameRoleSinceShare
Keith Sattler Individual Corporate OfficerBoard Member Commissioner Positi Jan 1, 2012
Corporate DirectorBoard Member Commissioner Positi Jan 1, 2012
Brandon Bowden Individual Corporate OfficerBoard Member Commissioner Aug 31, 2017
Corporate DirectorBoard Member Commissioner Aug 31, 2017
Glen Bestebreur Individual Corporate OfficerBoard Member Secretary & Commiss Oct 28, 2010
Corporate DirectorBoard Member Secretary & Commiss Oct 28, 2010
Kit Watson Individual Corporate OfficerBoard Member Commissioner Jan 1, 2016
Corporate DirectorBoard Member Commissioner Jan 1, 2016
Stephen Kenny Individual Corporate OfficerBoard Member President Position Aug 13, 1984
Corporate DirectorBoard Member President Position Aug 13, 1984
Craig Marks Individual Corporate OfficerCeo Aug 29, 2016 100%
Corporate DirectorCeo Aug 29, 2016 100%
W-2 Managing EmployeeCeo Aug 29, 2016 100%
Sharon a Dietrich Individual Corporate OfficerBoard Member Secretary Position Mar 3, 2014
Corporate DirectorBoard Member Secretary Position Mar 3, 2014

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Prosser PMH Family MedicineProsser, WA, CCN 508582 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 15, 2017
Prosser Memorial Health Grandview ClinicGrandview, WA, CCN 508588 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 7, 2019

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 260

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 260

Affiliated clinicians 237

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

View all 237

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738540800000",
    "number": "1306897681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84112",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245412",
            "telephone_number": "509-786-2222",
            "fax_number": "509-786-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PROSSER HEALTH DR",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993507832",
            "telephone_number": "509-786-2222",
            "fax_number": "509-788-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-786-2222"
    },
    "taxonomies": [
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "WA",
            "license": "000056",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WA",
            "license": "000056",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WA",
            "license": "HAC.FS.00000046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PMH L & I",
            "identifier": "001944",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I PROF/SERV",
            "identifier": "0082383",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7118334",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7888803",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7064801",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3303807",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9048463",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prosser Memorial Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prosser Memorial Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prosser, WA

Sources for this page

Verify at the official NPI Registry.