Active NPI
GHCH Physician Services, LLC
- Surgery Physician
- Aberdeen, WA
National Provider Identifier
1326217670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- GHCH PHYSICIAN SERVICES, LLC
- Practice address
- 1006 North H Street
Aberdeen, WA 98520 - Phone
- (360) 537-6186
- NPI assigned
- Feb 20, 2008
- Organization subpart
- Yes
- Parent organization
- GHCH PHYSICIAN SERVICES, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tanya L Stott
- Title
- Human Resource Manager
- Phone
- (360) 537-6186
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | |||
| Cardiovascular Disease Physician | 207RC0000X | |||
| Interventional Cardiology Physician | 207RI0011X | |||
| Obstetrics & Gynecology Physician | 207V00000X | |||
| Orthopaedic Surgery Physician | 207X00000X | |||
| Otolaryngology Physician | 207Y00000X | |||
| Pediatrics Physician | 208000000X | |||
| Surgery Physician | 208600000X | Primary | ||
| Urology Physician | 208800000X |
Addresses
Primary practice location
1006 North H Street
Aberdeen, WA 98520
Mailing address
PO Box 1787
Aberdeen, WA 98520-0292
Phone (360) 537-6186
Other names 1
- Harbor Medical Group
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090123000367 | WA | Part B Supplier - Clinic/Group Practice | 7416011184 |
Receives reassigned benefits from 42 practitioners Practice locations: Montesano, WA; Hoquiam, WA; Aberdeen, WA |
National Provider Directory
National Provider Directory- Part of
- GHCH Physician Services LLC
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
1006 N H St
Fl 5
Aberdeen, WA 98520
Phone (360) 537-6414
1006 N H St
#4
Aberdeen, WA 98520
Ownership & related parties
All disclosed owners & managing parties 13
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Timothy Kuhn | Operational/Managerial Control | Jan 1, 2013 | 100% |
| James Manenica | Operational/Managerial Control | Jan 1, 2013 | 100% |
| Thomas Jensen | Operational/Managerial Control | Sep 7, 2010 | 100% |
| Curtis M Janhunen | Operational/Managerial Control | Jan 1, 2013 | 100% |
| Tyrone Palmer | Operational/Managerial Control | Jan 1, 2013 | 100% |
| Grays Harbor Community Hospital | 5% Or Greater Direct Ownership Interest | Jan 9, 2008 | 100% |
| Timothy Howden | Operational/Managerial Control | Jun 1, 2007 | 100% |
| Maryann M Welch | Operational/Managerial Control | Jan 1, 2013 | 100% |
| Peter R Scroggs | Operational/Managerial Control | Jan 1, 2013 | 100% |
| Robert L McCauley | Operational/Managerial Control | Jan 1, 2013 | 100% |
| Barbara McCullough | Operational/Managerial Control | Jan 1, 2013 | 100% |
| Gregory May | Operational/Managerial Control | Jan 1, 2013 | 100% |
| David Monsen | Operational/Managerial Control | Jan 1, 2013 | 100% |
Practitioners & affiliated clinicians
Practitioners 59
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Gig Harbor, WA
- NPI 1356875959
Orthopaedic Surgery, WA
-
- Orthopaedic Surgery Physician
- Aberdeen, WA
- NPI 1265401533
Orthopaedic Surgery, WA
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Salt Lake City, UT
- NPI 1396713020
Orthopaedic Surgery, WA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203465600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1652227200000",
"number": "1326217670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1787",
"city": "ABERDEEN",
"state": "WA",
"postal_code": "985200292",
"telephone_number": "360-537-6186",
"fax_number": "360-537-6192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1006 NORTH H STREET",
"city": "ABERDEEN",
"state": "WA",
"postal_code": "98520",
"telephone_number": "360-537-6186"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GHCH PHYSICIAN SERVICES, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GHCH PHYSICIAN SERVICES, LLC",
"enumeration_date": "2008-02-20",
"last_updated": "2022-05-11",
"certification_date": "2022-05-11",
"status": "A",
"authorized_official_last_name": "STOTT",
"authorized_official_first_name": "TANYA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "HUMAN RESOURCE MANAGER",
"authorized_official_telephone_number": "360-537-6186"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Interventional Cardiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
},
{
"code": "208800000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Harbor Medical Group",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Harbor Medical Group",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Aberdeen, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.