NPIMap

Organization Active NPI

Sunnyside Home Health

  • Home Health Agency
  • Sunnyside, WA
National Provider Identifier
1669918405
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SUNNYSIDE HOME HEALTH
Practice address
812 Miller Ave
Suite a
Sunnyside, WA 98944-2374
Phone
(509) 837-1567
Fax
(509) 836-0175
NPI assigned
Jan 18, 2017
Last updated
Jan 18, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Authorized official

Name
Ms. Kim Lawson
Title
Business Office Manager
Phone
(509) 837-1617

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

812 Miller Ave
Suite a
Sunnyside, WA 98944-2374

Mailing address

PO Box 719
Sunnyside, WA 98944-0719
Phone (509) 837-1614

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170413001060 WA Part A Provider - Home Health Agency 5698051241 Practice locations: Sunnyside, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669918405. Details of each certification follow.

Home health agency certification: CCN 507126

Legal name
SUNNYSIDE HOME HEALTH
Doing business as
ASTRIA HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 12, 2017
Last certification
Sep 12, 2017
Ownership / control type
Non-Profit
Organization structure
CorporationProprietary
Incorporated
Nov 21, 2016 in WA
Enrollment address
812 Miller Ave
Ste a
Sunnyside, WA 98944-2377
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Sunnyside Home HealthCCN 507126 · All quality measures
Overall star rating
2 of 5
Ownership
Non-Profit
Certified
Sep 12, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2124446Astria Sunnyside Home Health812 Miller Ave Ste a, Sunnyside, WA 98944Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Part of
Sunnyside Community Hospital Outpatient Center 5

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

812 Miller Ave
Ste A
Sunnyside, WA 98944
Phone (509) 837-1567

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Sunnyside Community Hospital Association Organization, Sunnyside, WA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Nov 21, 2016 100%
Operational/Managerial Control Nov 21, 2016 100%
Brian P Gibbons Individual Corporate OfficerPresident, Ceo Jan 26, 2017
W-2 Managing EmployeePresident, Ceo Jan 26, 2017
Operational/Managerial ControlPresident, Ceo Jan 26, 2017
Castulo T Arteaga Individual Corporate DirectorBoard Member Nov 21, 2016 100%
Peggy I Brewer Individual Corporate DirectorBoard Member Nov 21, 2016 10%
Maxwell Owens Individual Corporate Officer Jan 1, 2020
Corporate Director Jan 1, 2020
W-2 Managing Employee Jan 1, 2020
Christina Rivas Individual Corporate OfficerOfficer Jan 1, 2022
Astria Health Organization, Sunnyside, WA Non-profit 5% Or Greater Indirect Ownership Interest Nov 21, 2016 100%
Asusena Fonseca Individual Corporate DirectorBoard Member Nov 21, 2016 100%

Owners & managing parties with NPI records 9

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

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Practitioners 14

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 14

Affiliated clinicians 5

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": "1484697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1669918405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989440719",
            "telephone_number": "509-837-1614",
            "fax_number": "509-837-4908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 MILLER AVE",
            "address_2": "SUITE A",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442374",
            "telephone_number": "509-837-1567",
            "fax_number": "509-836-0175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYSIDE HOME HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION",
        "enumeration_date": "2017-01-18",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "509-837-1617",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, WA

Sources for this page

Verify at the official NPI Registry.