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Organization Active NPI

Kittitas County Public Hospital Dist 1

  • Home Health Agency
  • Ellensburg, WA
National Provider Identifier
1376561654
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
IS-320 Issued in WA
Legal business name
KITTITAS COUNTY PUBLIC HOSPITAL DIST 1
Practice address
309 E Mountain View Ave
Ellensburg, WA 98926-3768
Phone
(509) 925-8499
Fax
(509) 925-8450
NPI assigned
Jul 17, 2006
Organization subpart
Yes
Parent organization
KITTITAS COUNTY PUBLIC HOSPITAL DIST 1As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Authorized official

Name
Mrs. Aggie Sprague
Title
Manager Transitional Care Home Heal
Phone
(509) 962-7438

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X IS-320 WA Primary

Addresses

Primary practice location

309 E Mountain View Ave
Ellensburg, WA 98926-3768

Mailing address

P.O. Box 799
Ellensburg, WA 98926
Phone (509) 962-7438

Other identifiers 4

IdentifierTypeStateIssuer
009490004OtherWAGROUP HEALTH COOPERATIVE
44265OtherWAST OF WA LABOT & INDUSTRI
9036823MedicaidWA
152OtherWABLUE CROSS OF WASHINGTON

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050103000735 WA Part A Provider - Home Health Agency 0547179608 Practice locations: Ellensburg, WA

Home health agency certification: CCN 507097

Legal name
KITTITAS COUNTY PUBLIC HOSPITAL DIST 1
Doing business as
KITTITAS VALLEY HEALTHCARE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 4, 1993
Last certification
Aug 12, 2021
Ownership / control type
Government Operated
Organization structure
OtherNon-profit
Incorporated
Dec 1, 1964 in WA
Enrollment address
1506 E Radio Rd
Ellensburg, WA 98926-9589

Other NPIs with the same Medicare PAC ID 6

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Kittitas Valley Home Health & HospiceCCN 507097
Overall star rating
3 of 5
Ownership
Government Operated
Certified
Aug 4, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Kittitas County Public Hospital District 116 organizations share this tax ID, including this one
Part of
Kittitas County Public Hospital District 1

Other organizations with this tax ID 15

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

View all 15

Locations

309 E Mountain View Ave
Ellensburg, WA 98926
Phone (509) 925-8499

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Kittitas County Public Hospital Dist 1 Organization, Ellensburg, WA 5% Or Greater Direct Ownership Interest Jan 1, 1964 100%
Operational/Managerial Control Jan 1, 1964 100%
Jennifer Reed Individual Corporate OfficerCfo Jan 1, 2025 100%
W-2 Managing EmployeeAd;Cfo Jan 1, 2025 100%
Michelle Sexton Individual W-2 Managing EmployeeBusiness Office Director Oct 1, 2019
Jason Adler Individual Corporate OfficerCeo Jan 1, 2025 100%
W-2 Managing EmployeeAd;Ceo Jan 1, 2025 100%

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Kittitas Valley HealthcareEllensburg, WA, CCN 501333 Hospital Operational/Managerial Control (100%) Jan 1, 1966
Kittitas Valley HealthcareEllensburg, WA, CCN 50Z333 Hospital Operational/Managerial Control (100%) Jan 1, 2004
Kittitas Valley Comm Hospital HospiceEllensburg, WA, CCN 501529 Hospice 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 25, 2008
Oct 3, 2011
Kittitas Valley Healthcare Family Medicine Cle ElumCle Elum, WA, CCN 508541 Rural health clinic Operational/Managerial Control (100%) Jul 1, 2005
Kittitas Valley Healthcare Internal MedicineEllensburg, WA, CCN 508545 Rural health clinic Operational/Managerial Control (100%) Jul 26, 2007
Medical Arts Center ClinicEllensburg, WA, CCN 508553 Rural health clinic Operational/Managerial Control (100%) Nov 1, 1966

Owned or controlled facilities with NPI records 6

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 82

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

View all 82

Affiliated clinicians 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517356800000",
    "number": "1376561654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 799",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "98926",
            "telephone_number": "509-962-7438",
            "fax_number": "509-925-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E MOUNTAIN VIEW AVE",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263768",
            "telephone_number": "509-925-8499",
            "fax_number": "509-925-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITTITAS COUNTY PUBLIC HOSPITAL DIST 1",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KITTITAS COUNTY PUBLIC HOSPITAL DIST 1",
        "enumeration_date": "2006-07-17",
        "last_updated": "2018-01-31",
        "status": "A",
        "authorized_official_last_name": "SPRAGUE",
        "authorized_official_first_name": "AGGIE",
        "authorized_official_title_or_position": "MANAGER TRANSITIONAL CARE HOME HEAL",
        "authorized_official_telephone_number": "509-962-7438",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WA",
            "license": "IS-320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH COOPERATIVE",
            "identifier": "009490004",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST OF WA LABOT & INDUSTRI",
            "identifier": "44265",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9036823",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF WASHINGTON",
            "identifier": "152",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellensburg, WA

Sources for this page

Verify at the official NPI Registry.