NPIMap

Organization Active NPI

Kittitas County Public Hospital Dist 1

Doing business as Kittitas Valley Healthcare Hospice

  • Community Based Hospice Care Agency
  • Ellensburg, WA
National Provider Identifier
1639197882
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
IS-320 Issued in WA
Legal business name
KITTITAS COUNTY PUBLIC HOSPITAL DIST 1
Doing business as
Kittitas Valley Healthcare Hospice
Practice address
1505 E Radio Rd
Ellensburg, WA 98926-9589
Phone
(509) 962-7438
Fax
(509) 925-8450
NPI assigned
Jul 17, 2006
Last updated
Oct 14, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
KITTITAS COUNTY PUBLIC HOSPITAL DIST 1As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Authorized official

Name
Lisa Michelle Gott
Title
Director Revenue Cycle Operations
Phone
(509) 962-7424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X IS-320 WA Primary

Addresses

Primary practice location

1505 E Radio Rd
Ellensburg, WA 98926-9589

Mailing address

PO Box 799
Ellensburg, WA 98926-1921
Phone (509) 962-7438

Other identifiers 4

IdentifierTypeStateIssuer
152OtherWABLUE CROSS-HOSPICE
835OtherWAGROPU HLTH COOP-HOSPICE
91757683OtherWAUNIFORM MED PLAN-HOSPICE
3990314MedicaidWA

Other names 1

  • Kittitas Valley Healthcare Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050103000881 WA Part A Provider - Hospice 0547179608 Practice locations: Ellensburg, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639197882. Details of each certification follow.

Hospice certification: CCN 501529

Legal name
KITTITAS COUNTY PUBLIC HOSPITAL DIST 1
Doing business as
KITTITAS VALLEY COMM HOSPITAL HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 29, 1994
Last certification
May 4, 2022
Ownership / control type
Combination Government and Nonprofit
Organization structure
OtherNon-profit
Incorporated
Dec 1, 1964 in WA
Enrollment address
1506 E Radio Rd
Ellensburg, WA 98926-9589

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Kittitas Valley Home Health & HospiceCCN 501529 · All quality measures
Ownership
Government
Certified
Apr 29, 1994
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Kittitas Co Pub Hos Dis 116 organizations share this tax ID, including this one
Part of
Kittitas Co Pub Hos Dis 1

Other organizations with this tax ID 15

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

View all 15

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Kittitas County Public Hospital Dist 1 Organization, Ellensburg, WA 5% Or Greater Direct Ownership Interest Jul 25, 2008
Operational/Managerial Control Oct 3, 2011
Jennifer Reed Individual W-2 Managing EmployeeAd;Cfo Jun 1, 2025
Michelle Sexton Individual W-2 Managing Employee Oct 1, 2019
Jason Adler Individual W-2 Managing EmployeeAd;Ceo Jan 1, 2025

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Kittitas Valley HealthcareEllensburg, WA, CCN 501333 Hospital Operational/Managerial Control (100%) Jan 1, 1966
Kittitas Valley HealthcareEllensburg, WA, CCN 50Z333 Hospital Operational/Managerial Control (100%) Jan 1, 2004
Kittitas Valley Healthcare Home HealthEllensburg, WA, CCN 507097 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1964
Jan 1, 1964
Kittitas Valley Healthcare Family Medicine Cle ElumCle Elum, WA, CCN 508541 Rural health clinic Operational/Managerial Control (100%) Jul 1, 2005
Kittitas Valley Healthcare Internal MedicineEllensburg, WA, CCN 508545 Rural health clinic Operational/Managerial Control (100%) Jul 26, 2007
Medical Arts Center ClinicEllensburg, WA, CCN 508553 Rural health clinic Operational/Managerial Control (100%) Nov 1, 1966

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791936000000",
    "number": "1639197882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 799",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989261921",
            "telephone_number": "509-962-7438",
            "fax_number": "509-925-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 E RADIO RD",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989269589",
            "telephone_number": "509-962-7438",
            "fax_number": "509-925-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITTITAS COUNTY PUBLIC HOSPITAL DIST 1",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KITTITAS COUNTY PUBLIC HOSPITAL DIST 1",
        "enumeration_date": "2006-07-17",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A",
        "authorized_official_last_name": "GOTT",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR REVENUE CYCLE OPERATIONS",
        "authorized_official_telephone_number": "509-962-7424"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WA",
            "license": "IS-320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-HOSPICE",
            "identifier": "152",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROPU HLTH COOP-HOSPICE",
            "identifier": "835",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIFORM MED PLAN-HOSPICE",
            "identifier": "91757683",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3990314",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kittitas Valley Healthcare Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellensburg, WA

Sources for this page

Verify at the official NPI Registry.