Grays Harbor House Hospitalist
Organization Active NPI General Acute Care Hospital · Aberdeen, WA
NPI 1659411486 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1659411486
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- License
- 282N00000X (WA)
- Legal business name
- GRAYS HARBOR HOUSE HOSPITALIST
- Practice address
- 915 Anderson Dr
Aberdeen, WA 98520-1006 - Phone
- (360) 537-6113
- NPI assigned
- Feb 8, 2007
- Organization subpart
- No
Authorized official
- Name
- Art Tanner
- Title
- Cfo
- Phone
- (360) 537-6113
Other NPIs on the same Medicare enrollment 11
Practitioners 33
-
Melody Albano, DNP, ARNP
-
Ann Marie Allen, ARNP FNP-C
-
Julie Ann Day, FNP-C
-
Andrew Field, DPT
-
Ben Goold, MD
-
Cheryl A Graf, ARNP
-
Daniel J Hahn, PA-C
-
Monica Hallak, ARNP
-
Salam Y Hallak, M.D.
-
Erin A Hashiro, DPT
-
Ann Elizabeth Heikel, OTR
-
Dennis P. Kirby, MD
-
Randi Jewell Lindstrom, D.O.
-
Timothy A Lipski, MD
-
Scott Wayne Miller, DPT
-
Michael P Rome, MD
-
Craig J Teveliet, MD
-
Driss Berrada, MD
-
Rachele Sara Cerrone, DPT, ATC
-
Shen Te Steven Hsu, M.D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031231000081 | WA | Part B Supplier - Clinic/Group Practice | 3577462365 |
Receives reassigned benefits from 213 practitioners 11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Aberdeen, WA; Hoquiam, WA; Montesano, WA; Westport, WA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 282N00000X | WA | Yes |
Addresses
Primary practice location
915 Anderson Dr
Aberdeen, WA 98520-1006
Mailing address
PO Box 1558
Aberdeen, WA 98520-0269
Phone (360) 537-6113
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7134604 | Medicaid | WA |
NPI Registry JSON
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1659411486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1558",
"city": "ABERDEEN",
"state": "WA",
"postal_code": "985200269",
"telephone_number": "360-537-6113",
"fax_number": "360-537-6146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 ANDERSON DR",
"city": "ABERDEEN",
"state": "WA",
"postal_code": "985201006",
"telephone_number": "360-537-6113"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRAYS HARBOR HOUSE HOSPITALIST",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-08",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "TANNER",
"authorized_official_first_name": "ART",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "360-537-6113"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "WA",
"license": "282N00000X",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7134604",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aberdeen, WA
- Grays Harbor County Treasurer
- Grays Harbor ER Physicians
- Grays Harbor Fire Protection District #10
- Grays Harbor Fire Protection District 2
- Grays Harbor Float & Wellness
- Grays Harbor Imaging LLC
- Grays Harbor Pediatrics, PLLC
- Grays Harbor Surgeons
- Grays Harbor Treatment Solutions
- Grays Harbor Vision Clinic, Inc.
All providers in Aberdeen, WA · General Acute Care Hospital in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.