NPIMap

Organization Active NPI

Public Hospital District #1-a of Whitman County

Doing business as Pullman Regional Hospital

  • Critical Access Hospital
  • Pullman, WA
National Provider Identifier
1366446767
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
H-172 Issued in WA
Legal business name
PUBLIC HOSPITAL DISTRICT #1-A OF WHITMAN COUNTY
Doing business as
Pullman Regional Hospital
Practice address
835 SE Bishop Blvd
Pullman, WA 99163-5512
Phone
(509) 332-2514
Fax
(509) 332-0731
NPI assigned
Jun 13, 2005
Last updated
Oct 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Matt Forge, CEO
Title
Chief Executive Officer
Phone
(509) 336-7300

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X
Radiologic Technologist 247100000X
Critical Access Hospital Clinic/Center 261QC0050X
Urgent Care Clinic/Center 261QU0200X
Critical Access Hospital 282NC0060X H-172 WA Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

835 SE Bishop Blvd
Pullman, WA 99163-5512

Mailing address

835 SE Bishop Blvd
Pullman, WA 99163-5512
Phone (509) 332-2514

Other identifiers 7

IdentifierTypeStateIssuer
003221800MedicaidID
7030661MedicaidWA
003221990MedicaidID
2590OtherWALABOR & INDUSTRIES (FAC)
077OtherWAPREMERA BLUE CROSS
3303708MedicaidWA
82105OtherWALABOR & IND. (PHYS GROUP)

Other names 1

  • Pullman Regional Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040223000506 WA Part B Supplier - Clinic/Group Practice 8325934987 Receives reassigned benefits from 151 practitioners
1 other NPI on this enrollment
Practice locations: Pullman, WA; Palouse, WA
O20070912000859 WA Part A Provider - Critical Access Hospital 8325934987 Receives reassigned benefits from 127 practitioners
Practice locations: Pullman, WA
O20240405000631 ID Part B Supplier - Clinic/Group Practice 8325934987 Receives reassigned benefits from 17 practitioners
Practice locations: Moscow, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366446767. Details of each certification follow.

Hospital certification: CCN 501331

Legal name
PUBLIC HOSPITAL DISTRICT #1-A OF WHITMAN COUNTY
Doing business as
PULLMAN REGIONAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jun 1, 2004
Last certification
May 17, 2012
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Incorporated
in WA
Enrollment address
835 SE Bishop Blvd
Pullman, WA 99163-5512

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Pullman Regional HospitalCCN 501331 · All quality measures
Overall star rating
2 of 5
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1420 S Blaine St
Moscow, ID 83843

1420 S Blaine St
Ste 5
Moscow, ID 83843
Phone (208) 882-2247

Msc 09 5030
Albuquerque, NM 87131

305 E Main St
Ste 102
Pullman, WA 99163

825 SE Bishop Blvd
Ste 100
Pullman, WA 99163

835 SE Bishop Blvd
Ste 201
Pullman, WA 99163

835 SE Bishop Blvd
Ste 401
Pullman, WA 99163
Phone (509) 332-2541

840 SE Bishop Blvd
Pullman, WA 99163

840 SE Bishop Blvd
Ste 100
Pullman, WA 99163

840 SE Bishop Blvd
Ste 103
Pullman, WA 99163
Phone (509) 336-7300

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Carly Scholz Individual W-2 Managing EmployeeMedical Staff Services Manager Jan 1, 2020
Matthew W Forge Individual Corporate OfficerCeo Oct 1, 2022
Joe Pitzer Individual Corporate Director Dec 19, 2007

Practitioners & affiliated clinicians

Practitioners 177

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 177

Affiliated clinicians 204

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

View all 204

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1366446767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 SE BISHOP BLVD",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635512",
            "telephone_number": "509-332-2514",
            "fax_number": "509-336-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 SE BISHOP BLVD",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635512",
            "telephone_number": "509-332-2514",
            "fax_number": "509-332-0731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DISTRICT #1-A OF WHITMAN COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "FORGE",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "509-336-7300",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WA",
            "license": "H-172",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003221800",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7030661",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003221990",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES (FAC)",
            "identifier": "2590",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "077",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3303708",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & IND. (PHYS GROUP)",
            "identifier": "82105",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pullman Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pullman Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pullman, WA

Sources for this page

Verify at the official NPI Registry.