NPIMap

Organization Active NPI

Public Hospital District No 2 Skagit County Washington

  • Rural Health Clinic/Center
  • Anacortes, WA
National Provider Identifier
1649288176
Registry record updated Jan 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
H134 Issued in WA
Legal business name
PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON
Practice address
2511 M Ave
Anacortes, WA 98221-3897
Phone
(260) 299-4211
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2013

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

Authorized official

Name
Ms. Elise J Cutter
Title
Chief Financial Officer
Phone
(360) 299-1301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X H134 WA Primary

Addresses

Primary practice location

2511 M Ave
Anacortes, WA 98221-3897

Mailing address

1211 24TH St
Anacortes, WA 98221-2557
Phone (360) 299-1300

Other identifiers 2

IdentifierTypeStateIssuer
0103225OtherWALABOR & INDUSTRIES
7105521MedicaidWA

Other names 1

  • Anacortes Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040513000726 WA Part A Provider - Rural Health Clinic 1153225198 Practice locations: Anacortes, WA

Rural health clinic certification: CCN 508505

Legal name
PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON
Doing business as
ANACORTES FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 10, 2000
Last certification
Sep 20, 2023
Ownership / control type
2B
Organization structure
OtherNon-profit
Incorporated
Nov 19, 1958 in WA
Enrollment address
2511 M Ave Ste B
Anacortes, WA 98221-2590
Related CCNs
500007

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Skagit County Hosp Dist5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Public Hospital District No 2 Skagit County Washington Organization, Anacortes, WA Non-profit Operational/Managerial Control Feb 10, 2005
Jan Iversen Individual Corporate Officer Jan 1, 2010
Operational/Managerial Control Jan 1, 2014
Elise J Cutter Individual Operational/Managerial ControlCfo Jan 1, 2013

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Island HospitalAnacortes, WA, CCN 500007 Hospital Operational/Managerial Control Jan 1, 2010
Fidalgo Medical AssociatesAnacortes, WA, CCN 508548 Rural health clinic Operational/Managerial Control Jan 1, 2010
Island Primary Care - OrcasEastsound, WA, CCN 508595 Rural health clinic Operational/Managerial Control (100%) Dec 30, 2020

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 3

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

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359072000000",
    "number": "1649288176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 24TH ST",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212557",
            "telephone_number": "360-299-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 M AVE",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982213897",
            "telephone_number": "260-299-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2013-01-25",
        "status": "A",
        "authorized_official_last_name": "CUTTER",
        "authorized_official_first_name": "ELISE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "360-299-1301",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WA",
            "license": "H134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0103225",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7105521",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anacortes Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anacortes, WA

Sources for this page

Verify at the official NPI Registry.