NPIMap

Organization Active NPI

Jefferson County Public Hospital District No 2

Doing business as Jefferson Healthcare

  • Home Health Agency
  • Port Townsend, WA
National Provider Identifier
1346210366
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
IS-349 Issued in WA
Legal business name
JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Doing business as
Jefferson Healthcare
Jefferson Healthcare Home Health and Hospice
Practice address
2500 W Sims Way Ste 300
Port Townsend, WA 98368-2234
Phone
(360) 385-0610
Fax
(360) 379-8259
NPI assigned
Jan 23, 2006
Last updated
Jan 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Authorized official

Name
David Hunsley, RN
Title
Director
Phone
(360) 385-0610

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X IS-349 WA Primary
Community Based Hospice Care Agency 251G00000X IS-349 WA

Addresses

Primary practice location

2500 W Sims Way Ste 300
Port Townsend, WA 98368-2234

Mailing address

2500 W Sims Way Ste 300
Port Townsend, WA 98368-2234
Phone (360) 385-0610

Other names 2

  • JEFFERSON HEALTHCARE Doing business as
  • Jefferson Healthcare Home Health and Hospice Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030406000000 WA Part A Provider - Home Health Agency 4789593708 Practice locations: Port Townsend, WA
O20101119000313 WA Part A Provider - Hospice 4789593708 Practice locations: Port Townsend, WA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1346210366. Details of each certification follow.

Home health agency certification: CCN 507050

Legal name
JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Doing business as
JEFFERSON HEALTHCARE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 18, 1979
Last certification
Apr 4, 2019
Ownership / control type
Government Operated
Organization structure
OtherNon-profit
Enrollment address
2500 W Sims Way
Ste 304
Port Townsend, WA 98368-2234

Hospice certification: CCN 501538

Legal name
JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Doing business as
JEFFERSON HEALTHCARE HOME HEALTH AND HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 5, 2002
Last certification
Mar 26, 2021
Ownership / control type
Government - County
Organization structure
CorporationProprietary
Incorporated
Jan 1, 1975 in WA
Enrollment address
2500 W Sims Way
Ste 304
Port Townsend, WA 98368-2234

Other NPIs with the same Medicare PAC ID 9

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Jefferson Healthcare Home HealthCCN 507050 · All quality measures
Overall star rating
2 of 5
Ownership
Government Operated
Certified
Dec 18, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Care Compare: Hospice

Medicare Care Compare
Listed as
Jefferson Healthcare Home HealthCCN 501538 · All quality measures
Ownership
Government
Certified
Aug 5, 2002
Medicare certification status
ActiveFrom the Provider of Services file

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
50D1011859Jefferson Healthcare Home Health & Hospice2500 W Sims Wy, Port Townsend, WA 98368Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
G C Forbes K D Forbes6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

2500 W Sims Way
Port Townsend, WA 98368

2500 W Sims Way
Ste 300
Port Townsend, WA 98368
Phone (360) 385-0610

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Bruce McComas Individual Corporate DirectorCommissioner Jan 1, 2018
Corporate DirectorBoard of Commissioner Jan 1, 2018
Cornelis Kolff Individual Corporate DirectorCommissioner Jan 1, 2016
Corporate Director Jan 1, 2016
Tyler Freeman Individual Corporate Officer Apr 19, 2021
Corporate OfficerCfo Jan 1, 2022
Operational/Managerial ControlCfo Jan 1, 2022
Brandie Manuel Individual Corporate OfficerChief Patient Care Officer Nov 12, 2020
Corporate DirectorChief Patient Care Officer Nov 12, 2020
Jefferson County Public Hospital District No 2 Organization, Port Townsend, WA Operational/Managerial Control Jan 1, 2003
Operational/Managerial Control Aug 5, 2010
Matthew W Ready Individual Corporate DirectorCommissioner May 1, 2015
Corporate Director Jan 10, 2014
Lawrence M Glenn Individual Corporate OfficerCeo Oct 4, 2010
Operational/Managerial ControlCeo Oct 4, 2010
Corporate Officer Oct 4, 2010
Corporate Director Oct 4, 2010
Jill E Buhler Individual Corporate DirectorCommissioner Apr 6, 2003
Corporate Director Aug 5, 2010
Marie L Dressler Individual Corporate DirectorCommissioner Jan 1, 2010
Corporate Director Jan 1, 2010

Owners & managing parties with NPI records 9

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

Practitioners & affiliated clinicians

Practitioners 42

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 42

Affiliated clinicians 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737331200000",
    "number": "1346210366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W SIMS WAY STE 300",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682234",
            "telephone_number": "360-385-0610",
            "fax_number": "360-379-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W SIMS WAY STE 300",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682234",
            "telephone_number": "360-385-0610",
            "fax_number": "360-379-8259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-23",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A",
        "authorized_official_last_name": "HUNSLEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "360-385-0610",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WA",
            "license": "IS-349",
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WA",
            "license": "IS-349",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JEFFERSON HEALTHCARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jefferson Healthcare Home Health and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Townsend, WA

Sources for this page

Verify at the official NPI Registry.