NPIMap

Organization Active NPI

Grant Co Public Hospital District 3

Doing business as Columbia Basin Family Medicine Clinic

  • Rural Health Clinic/Center
  • Ephrata, WA
National Provider Identifier
1457414799
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GRANT CO PUBLIC HOSPITAL DISTRICT 3
Doing business as
Columbia Basin Family Medicine Clinic
Practice address
220 Nat Washington Way
Ephrata, WA 98823-1982
Phone
(509) 754-3330
Fax
(509) 754-2351
NPI assigned
Dec 18, 2006
Last updated
Dec 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Authorized official

Name
Rosalinda Kibby, CPCS
Title
Executive Assistant
Phone
(509) 754-4631

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X WA Primary

Addresses

Primary practice location

220 Nat Washington Way
Ephrata, WA 98823-1982

Mailing address

220 Nat Washington Way
Ephrata, WA 98823-1982
Phone (509) 754-3330

Other names 1

  • Columbia Basin Family Medicine Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080904000111 WA Part A Provider - Rural Health Clinic 8325937675 Practice locations: Ephrata, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457414799. Details of each certification follow.

Rural health clinic certification: CCN 503985

Legal name
GRANT COUNTY PUBLIC HOSPITAL DISTRICT NO. 3
Doing business as
COLUMBIA BASIN FAMILY MEDICINE CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 29, 1994
Last certification
Sep 23, 2025
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Incorporated
Dec 15, 1950 in WA
Enrollment address
220 Nat Washington Way
Ephrata, WA 98823-1982
Related CCNs
501317

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).

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Rosalinda Kibby Individual W-2 Managing Employee Apr 7, 2009
Grant County Public Hospital District No. 3 Organization, Ephrata, WA Operational/Managerial Control May 8, 2007

Owners & managing parties with NPI records 3

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481068800000",
    "number": "1457414799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 NAT WASHINGTON WAY",
            "city": "EPHRATA",
            "state": "WA",
            "postal_code": "988231982",
            "telephone_number": "509-754-3330",
            "fax_number": "509-754-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 NAT WASHINGTON WAY",
            "city": "EPHRATA",
            "state": "WA",
            "postal_code": "988231982",
            "telephone_number": "509-754-3330",
            "fax_number": "509-754-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT CO PUBLIC HOSPITAL DISTRICT 3",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2016-12-07",
        "status": "A",
        "authorized_official_last_name": "KIBBY",
        "authorized_official_first_name": "ROSALINDA",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "509-754-4631",
        "authorized_official_credential": "CPCS"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Basin Family Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ephrata, WA

Sources for this page

Verify at the official NPI Registry.