Kittitas Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

KITTITAS MEDICAL LLC

Practice address

709 S Main St
Ellensburg, WA 98926-3640

Phone

(509) 929-3000

Fax

(509) 834-7414

NPI assigned

Sep 1, 2015

Last updated

Feb 1, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Erik MickelsonNPI 1801660063

Title

Manager

Phone

(509) 929-3000

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

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

Medicare medical equipment & supply locations

Locations

Practitioners 1

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.

• Erik Mickelson, MDIV

  • Counselor
  • Yakima, WA
  • NPI 1801660063

  Oxygen Equipment & Supplies

  NPD Authorized official

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612137600000",
    "number": "1356718746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 S MAIN ST",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263640",
            "telephone_number": "509-929-3000",
            "fax_number": "509-834-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 S MAIN ST",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263640",
            "telephone_number": "509-929-3000",
            "fax_number": "509-834-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITTITAS MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A",
        "authorized_official_last_name": "MICKELSON",
        "authorized_official_first_name": "ERIK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "509-929-3000"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kittitas County Public Hospital Dist 1 (KVH Hospitalist)
• Kittitas County Public Hospital District (Kittitas Valley Community Hospital)
• Kittitas County Public Hospital District #1 (Kittitas Valley Healthcare)
• Kittitas County Public Hospital District #1 (Kittitas Valley Healthcare Pharmacy)
• Kittitas County Public Hospital District #1
• Kittitas Valley Open MRI Corp
• Kittitas Valley Urgent Care PLLC (Kittitas Valley Urgent Care)
• Joshua Klein
• Clinton John Knight, PHARMD
• McKenzie Knowlden

• Durable Medical Equipment & Medical Supplies in Ellensburg, WA
• Providers in Ellensburg, WA by specialty
• Durable Medical Equipment & Medical Supplies in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.