Organization Active NPI

Whidbey Island Public Hospital District

  • Psychiatry Physician
  • Rocky Mount, NC
National Provider Identifier
1568056943
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Practice address
1103 Deerchase Dr
Rocky Mount, NC 27804-6438
Phone
(360) 678-5151
NPI assigned
Feb 25, 2021
Last updated
Feb 25, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Authorized official

Name
Ronald Telles
Title
Ceo
Phone
(360) 678-7656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

1103 Deerchase Dr
Rocky Mount, NC 27804-6438

Mailing address

101 N Main St
Coupeville, WA 98239-3413
Phone (360) 678-5151

Other names 1

  • WhidbeyHealth Telehealth Other name

National Provider Directory

National Provider Directory
Part of
Whidbey Island Pub Hospital

NPI Registry JSON

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614211200000",
    "number": "1568056943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N MAIN ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982393413",
            "telephone_number": "360-678-5151",
            "fax_number": "360-678-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 DEERCHASE DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278046438",
            "telephone_number": "360-678-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A",
        "authorized_official_last_name": "TELLES",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-678-7656"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WhidbeyHealth Telehealth",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.