NPIMap

Organization Active NPI

Columbia Valley Community Health

Doing business as Columbia Valley Community Health Chelan

  • Federally Qualified Health Center (FQHC)
  • Chelan, WA
National Provider Identifier
1356374698
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COLUMBIA VALLEY COMMUNITY HEALTH
Doing business as
Columbia Valley Community Health Chelan
Practice address
105 S Apple Blossom Dr
Chelan, WA 98816-8810
Phone
(509) 682-6000
Fax
(509) 682-6192
NPI assigned
Jul 9, 2006
Last updated
Dec 23, 2020By the provider in NPPES
Organization subpart
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Authorized official

Name
David Olson
Title
Cfo
Phone
(509) 664-3528

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

105 S Apple Blossom Dr
Chelan, WA 98816-8810

Mailing address

600 Orondo Ave
Ste 1
Wenatchee, WA 98801-2800
Phone (509) 662-6000

Other names 1

  • Columbia Valley Community Health Chelan Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chelan.medical.2@10575.direct.athenahealth.com Direct

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040227000599 WA Part B Supplier - Clinic/Group Practice 7113813874 Receives reassigned benefits from 99 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wenatchee, WA; East Wenatchee, WA; Chelan, WA
O20040607001609 WA Part A Provider - Federally Qualified Health Center (FQHC) 7113813874 Practice locations: Chelan, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356374698. Details of each certification follow.

Federally qualified health center certification: CCN 501883

Legal name
COLUMBIA VALLEY COMMUNITY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 14, 2004
Last certification
Jul 14, 2004
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Feb 22, 1973 in WA
Enrollment address
105 S Apple Blossom Dr
Chelan, WA 98816-8810

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Part of
Columbia Valley Community Health East Wenatchee Pharmacy

Interoperability endpoints

  • Direct secure messaging: chelan.medical.2@10575.direct.athenahealth.com

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
John Swenson Individual Corporate Director Sep 12, 2017
David Olson Individual Corporate OfficerCeo Jun 30, 2016
W-2 Managing Employee Jun 30, 2016
Alfredo Ortiz Individual Corporate Director Apr 1, 2019
Joan Alway Individual Corporate DirectorPresident May 15, 2013
Malcolm a Butler Individual W-2 Managing Employee Jan 1, 1995
Kristina Stepper Individual Corporate OfficerBoard Member May 15, 2013
Summer Kelley Individual W-2 Managing Employee Jun 5, 2019
Teresa Zepeda Soda Individual Corporate DirectorSecretary Apr 8, 2014
Manuel Navarro Individual Corporate OfficerCoo Jul 1, 2019
W-2 Managing Employee Jul 1, 2019
Robert H Scott Individual Corporate DirectorBoard Member Jul 3, 2004
Danielle Noell Individual W-2 Managing Employee Oct 24, 2011
Jeffery Hinckley Individual W-2 Managing Employee Nov 1, 2018
Shaun Koos Individual Corporate Director Jan 3, 2017
Columbia Valley Community Health Organization, Wenatchee, WA Non-profit Operational/Managerial Control Jun 1, 1975
Ron Feld Individual Corporate Director Jul 1, 2019
Loly Larson Individual Corporate DirectorBoard Member Jul 3, 2004
Michael Machado Individual Corporate Director Sep 12, 2017

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 9

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

FacilityTypeRoleSince
East Wenatchee MedicalEast Wenatchee, WA, CCN 501936 Federally qualified health center Operational/Managerial Control (100%) Apr 13, 2012
CVCH Behavioral HealthWenatchee, WA, CCN 501953 Federally qualified health center Operational/Managerial Control Feb 22, 1973
Wenatchee Valley College ClinicWenatchee, WA, CCN 941041 Federally qualified health center Operational/Managerial Control Jan 2, 2018
Hope HealthWenatchee, WA, CCN 941046 Federally qualified health center Operational/Managerial Control Jan 8, 2019
Lincoln Elementary School ClinicWenatchee, WA, CCN 941053 Federally qualified health center Operational/Managerial Control Sep 5, 2017
Children's Behavioral HealthWenatchee, WA, CCN 941052 Federally qualified health center Operational/Managerial Control Jul 20, 2015
New PathWenatchee, WA, CCN 941054 Federally qualified health center Operational/Managerial Control Jul 1, 2019
Columbia Valley Community HealthEast Wenatchee, WA, CCN 501030 Federally qualified health center Operational/Managerial Control (100%) Jun 1, 1975
980 Psychiatric MedicalEast Wenatchee, WA, CCN 501066 Federally qualified health center Operational/Managerial Control (100%) Jun 1, 1975

Owned or controlled facilities with NPI records 5

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

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608681600000",
    "number": "1356374698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ORONDO AVE",
            "address_2": "STE 1",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012800",
            "telephone_number": "509-662-6000",
            "fax_number": "509-664-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S APPLE BLOSSOM DR",
            "city": "CHELAN",
            "state": "WA",
            "postal_code": "988168810",
            "telephone_number": "509-682-6000",
            "fax_number": "509-682-6192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA VALLEY COMMUNITY HEALTH",
        "organizational_subpart": "YES",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-12-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "509-664-3528"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chelan.medical.2@10575.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "105 S Apple Blossom Dr",
            "city": "Chelan",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988168810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Columbia Valley Community Health Chelan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chelan, WA

Sources for this page

Verify at the official NPI Registry.