NPIMap

Jefferson County Public Hospital District No 2

Organization Active NPI Home Health Agency · Port Townsend, WA

NPI 1346210366 · NPPES record last updated Jan 20, 2025

Key facts

NPI
1346210366
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
License
IS-349 (WA)
Legal business name
JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
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
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 9

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

Other NPIs with the same Medicare PAC ID 9

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

Corporate family (same tax ID) 5

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

Practitioners 188

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

View all 188

Affiliated clinicians 34

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

View all 34

Medicare Care Compare: Home health agency

Listed as
Jefferson Healthcare Home Health CCN 507050
Overall star rating
★★☆☆☆ 2 of 5
Ownership
Government Operated
Certified
Dec 18, 1979
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Source: Medicare Care Compare.

Medicare Care Compare: Hospice

Listed as
Jefferson Healthcare Home Health CCN 501538
Ownership
Government
Certified
Aug 5, 2002
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D1011859Jefferson Healthcare Home Health & Hospice
2500 W Sims Wy, Port Townsend, WA 98368		Certificate of waiverApr 4, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in WA

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
Other · Non-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
Corporation · Proprietary
Incorporated
Jan 1, 1975 in WA
Enrollment address
2500 W Sims Way
Ste 304
Port Townsend, WA 98368-2234

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 Director
Commissioner		 Jan 1, 2018
Corporate Director
Board of Commissioner		 Jan 1, 2018
Cornelis Kolff
Individual 		Corporate Director
Commissioner		 Jan 1, 2016
Corporate Director Jan 1, 2016
Tyler Freeman
Individual 		Corporate Officer Apr 19, 2021
Corporate Officer
Cfo		 Jan 1, 2022
Operational/Managerial Control
Cfo		 Jan 1, 2022
Brandie Manuel
Individual 		Corporate Officer
Chief Patient Care Officer		 Nov 12, 2020
Corporate Director
Chief 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 Director
Commissioner		 May 1, 2015
Corporate Director Jan 10, 2014
Lawrence M Glenn
Individual 		Corporate Officer
Ceo		 Oct 4, 2010
Operational/Managerial Control
Ceo		 Oct 4, 2010
Corporate Officer Oct 4, 2010
Corporate Director Oct 4, 2010
Jill E Buhler
Individual 		Corporate Director
Commissioner		 Apr 6, 2003
Corporate Director Aug 5, 2010
Marie L Dressler
Individual 		Corporate Director
Commissioner		 Jan 1, 2010
Corporate Director Jan 1, 2010

Medicare enrollment records

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

National Provider Directory

Tax ID family
Jefferson General Hosp (6 organizations share this tax ID)

Locations

2500 W Sims Way
Port Townsend, WA 98368

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

1010 Sheridan St
Ste 201
Port Townsend, WA 98368
Phone (360) 385-5444

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X IS-349 WA Yes
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 identifiers

IdentifierTypeStateIssuer
3990835MedicaidWA
9506809MedicaidWA

Other names

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

Other providers in Port Townsend, WA

All providers in Port Townsend, WA · Home Health Agency in Washington

Sources for this page

Verify at the official NPI Registry.