NPIMap

Organization Active NPI

Tri-Cities Community Health

  • Nurse Practitioner
  • Pasco, WA
National Provider Identifier
1528241007
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
TRI-CITIES COMMUNITY HEALTH
Practice address
507 N 5TH Ave
Pasco, WA 99301-5201
Phone
(509) 543-1975
NPI assigned
Dec 7, 2007
Last updated
Jan 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Authorized official

Name
Ms. Kristy Needham
Title
Ceo
Phone
(509) 547-2204

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X Primary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Obstetrics & Gynecology Physician 207V00000X
Pediatrics Physician 208000000X

Addresses

Primary practice location

507 N 5TH Ave
Pasco, WA 99301-5201

Mailing address

PO Box 1323
Pasco, WA 99301-1323
Phone (509) 547-2204

Other identifiers 1

IdentifierTypeStateIssuer
7139553MedicaidWA

Other names 1

  • 5th Avenue Urgent Care Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203000209 WA Part B Supplier - Clinic/Group Practice 4183517469 Receives reassigned benefits from 43 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pasco, WA; Richland, WA; Mesa, WA; Kennewick, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528241007. Details of each certification follow.

  • CCN 501920 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 501920

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
5TH AVENUE URGENT CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 9, 2009
Last certification
Oct 9, 2009
Ownership / control type
For profit – partnership
Facility address
507 N 5TH Ave
Pasco, WA 99301

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 41

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 41

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1528241007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1323",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993011323",
            "telephone_number": "509-547-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 N 5TH AVE",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993015201",
            "telephone_number": "509-543-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITIES COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "NEEDHAM",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-547-2204",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7139553",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "5th Avenue Urgent Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "5th Avenue Urgent Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pasco, WA

Sources for this page

Verify at the official NPI Registry.