NPIMap

Organization Active NPI

Peninsula Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Silverdale, WA
National Provider Identifier
1437830007
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PENINSULA COMMUNITY HEALTH SERVICES
Practice address
10182 Frontier Place NW, Ofc 5010
Silverdale, WA 98383
Phone
(360) 377-3776
NPI assigned
Jul 27, 2023
Last updated
Jul 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Authorized official

Name
Bruce Brazier
Title
Administrative Services Director
Phone
(360) 475-6715

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

10182 Frontier Place NW, Ofc 5010
Silverdale, WA 98383

Mailing address

PO Box 960
Bremerton, WA 98337-0212
Phone (360) 377-3776

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231121002596 WA Part A Provider - Federally Qualified Health Center (FQHC) 9436044781 Practice locations: Silverdale, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437830007. Details of each certification follow.

Federally qualified health center certification: CCN 501035

Legal name
PENINSULA COMMUNITY HEALTH SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 25, 2023
Last certification
Oct 25, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
10182 Frontier PL NW Ofc 5010
Silverdale, WA 98383-9408

National Provider Directory

National Provider Directory
Tax ID family
Peninsula Community50 organizations share this tax ID, including this one

Other organizations with this tax ID 49

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

View all 49

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Christopher J Cook Individual Corporate Director Dec 1, 2017
Jennifer Kreidler-Moss Individual Corporate OfficerCeo Aug 1, 2015
W-2 Managing EmployeeCeo Aug 1, 2015
Operational/Managerial ControlCeo Aug 1, 2015
Susan Astle Individual Corporate Director Dec 1, 2017
Monica Bernhard Individual Corporate Director Dec 1, 2019
Yolanda N Fong Individual Corporate Director Sep 18, 2024
Neal Schanbeck Individual Corporate DirectorCommunity Member Dec 17, 2025
Lolita Afalla Individual Corporate Director Sep 18, 2024
Leslie Jackson Individual Corporate DirectorPatient Member Nov 19, 2025
Mary Berglind Individual Corporate Director Feb 1, 2023
Kristin Lillegard Individual Corporate DirectorCommunity Member Feb 18, 2026
Alfred D Pinkham Individual Corporate Director Dec 1, 2017
Mary Dixon Individual Corporate DirectorPatient Member Aug 20, 2025
David Windom Individual Corporate Director Jan 1, 2021
Peninsula Community Health Services Organization, Bremerton, WA Non-profit 5% Or Greater Direct Ownership Interest Sep 8, 2023
Operational/Managerial Control Sep 8, 2023
Rogelio Valencia Individual Corporate Director Feb 1, 2023
Shannon Turner Individual Corporate Director May 21, 2025

All facility ownership & control disclosures 26

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

FacilityTypeRoleSince
Kitsap Community Health CentersPort Orchard, WA, CCN 501923 Federally qualified health center Operational/Managerial Control Jan 1, 2016
Peninsula Community Health ServicesBremerton, WA, CCN 501924 Federally qualified health center Operational/Managerial Control Jan 1, 2016
Peninsula Community Health ServicesBremerton, WA, CCN 941011 Federally qualified health center Operational/Managerial Control Jan 1, 2016
Peninsula Community Health Services BelfairBelfair, WA, CCN 941032 Federally qualified health center Operational/Managerial Control Apr 1, 2017
Peninsula Community Health Services KingstonKingston, WA, CCN 941033 Federally qualified health center Operational/Managerial Control May 1, 2017
Peninsula Community Health ServicesShelton, WA, CCN 941044 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2019
Peninsula Community Health ServicesBremerton, WA, CCN 941061 Federally qualified health center Operational/Managerial Control Sep 3, 2019
Peninsula Community Health ServicesBremerton, WA, CCN 941059 Federally qualified health center Operational/Managerial Control Sep 3, 2019
Peninsula Community Health ServicesBelfair, WA, CCN 941060 Federally qualified health center Operational/Managerial Control (100%) Sep 3, 2019
Peninsula Community Health ServicesBremerton, WA, CCN 941064 Federally qualified health center Operational/Managerial Control (100%) Sep 3, 2019
Peninsula Community Health ServicesSilverdale, WA, CCN 941070 Federally qualified health center Operational/Managerial Control May 1, 2020
Peninsula Community Health ServicesBremerton, WA, CCN 941074 Federally qualified health center Operational/Managerial Control (100%) Apr 20, 2020
Peninsula Community Health ServicesGig Harbor, WA, CCN 501005 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 17, 2021
Nov 17, 2021
Peninsula Community Health ServicesBremerton, WA, CCN 501006 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 31, 2022
May 31, 2022
Peninsula Community Health ServicesBremerton, WA, CCN 501010 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Sep 16, 2022
Sep 16, 2022
Peninsula Community Health ServicesPort Orchard, WA, CCN 501007 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Sep 24, 2021
Sep 24, 2021
Peninsula Community Health ServicesBremerton, WA, CCN 501008 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Oct 1, 2021
Oct 1, 2021
Peninsula Community Health ServicesKingston, WA, CCN 501013 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Apr 14, 2022
Apr 14, 2022
Peninsula Community Health ServicesBremerton, WA, CCN 501012 Federally qualified health center 5% Or Greater Direct Ownership Interest Apr 14, 2022
Peninsula Community Health ServicesBremerton, WA, CCN 501016 Federally qualified health center 5% Or Greater Direct Ownership Interest Aug 23, 2022
Peninsula Community Health ServicesSilverdale, WA, CCN 501015 Federally qualified health center 5% Or Greater Direct Ownership Interest Sep 24, 2021
Peninsula Community Health ServicesSilverdale, WA, CCN 501037 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Sep 8, 2023
Sep 8, 2023
Peninsula Community Health ServicesPoulsbo, WA, CCN 501038 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Nov 1, 2023
Nov 1, 2023
Peninsula Community Health ServicesPort Orchard, WA, CCN 501067 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 5, 2025
Peninsula Community Health ServicesPoulsbo, WA, CCN 501068 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jun 1, 2025
Jun 1, 2025
Peninsula Community Health ServicesBainbridge Island, WA, CCN 501079 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 12, 2026
Jan 12, 2026

Facilities with the same owner 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690416000000",
    "number": "1437830007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 960",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983370212",
            "telephone_number": "360-377-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10182 FRONTIER PLACE NW, OFC 5010",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "98383",
            "telephone_number": "360-377-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA COMMUNITY HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "BRAZIER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "ADMINISTRATIVE SERVICES DIRECTOR",
        "authorized_official_telephone_number": "360-475-6715"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.