NPIMap

Organization Active NPI

Sunnyside Community Hospital Outpatient Center 5

  • Clinic/Center
  • Yakima, WA
National Provider Identifier
1497107882
Registry record updated Jul 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SUNNYSIDE COMMUNITY HOSPITAL OUTPATIENT CENTER 5
Practice address
6101 Summitview Ave
Ste 200
Yakima, WA 98908-3048
Phone
(509) 573-3530
Fax
(509) 573-3535
NPI assigned
Jul 8, 2016
Organization subpart
Yes
Parent organization
SUNNYSIDE COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2016

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

Authorized official

Name
Amelia D Ledbetter
Title
Director of Operations
Phone
(573) 335-4715

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

6101 Summitview Ave
Ste 200
Yakima, WA 98908-3048

Mailing address

PO Box 719
Sunnyside, WA 98944-0719
Phone (509) 573-3530

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040227000194 WA Part B Supplier - Clinic/Group Practice 1658280896 Receives reassigned benefits from 139 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Zillah, WA; Yakima, WA; Union Gap, WA; Toppenish, WA; Sunnyside, WA; Prosser, WA; Grandview, WA

Other NPIs on the same Medicare enrollment 30

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

View all 30

National Provider Directory

National Provider Directory
Part of
Sunnyside Community Hos

Locations

355 Chardonnay Ave
Prosser, WA 99350
Phone (509) 781-6366

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467936000000",
    "number": "1497107882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989440719",
            "telephone_number": "509-573-3530",
            "fax_number": "509-573-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 SUMMITVIEW AVE",
            "address_2": "STE 200",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083048",
            "telephone_number": "509-573-3530",
            "fax_number": "509-573-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYSIDE COMMUNITY HOSPITAL OUTPATIENT CENTER 5",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNNYSIDE COMMUNITY HOSPITAL",
        "enumeration_date": "2016-07-08",
        "last_updated": "2016-07-08",
        "status": "A",
        "authorized_official_last_name": "LEDBETTER",
        "authorized_official_first_name": "AMELIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "573-335-4715"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.