Public Hospital District 1 of King County

Primary specialty

Institutional PharmacyTaxonomy code 3336I0012X

License

PHAR.CF.60213405 Issued in WA

Legal business name

PUBLIC HOSPITAL DISTRICT 1 OF KING COUNTY

Practice address

400 S 43Rd St
Renton, WA 98055-5714

Phone

(425) 917-6226

Fax

(425) 917-6248

NPI assigned

Apr 5, 2011

Organization subpart

No

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

Authorized official

Name

Kenneth Kenyon, PHARMD

Title

Director of Pharmacy,Ao

Phone

(425) 228-3440

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Prescription Pad Pharmacy South Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

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

• Public Hospital District 1 of King County

  • Community/Retail Pharmacy
  • Renton, WA
  • NPI 1104969518

  6901700731

  Same PAC ID
• Public Hospital District 1 of King County

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1649209230

  6901700731

  Same PAC ID

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

Medicare medical equipment & supply locations

Locations

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 2

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

• Public Hospital District 1 of King County

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1649209230

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574

  5% Or Greater Direct Ownership Interest

  CMS ownership

Practitioners 100

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William A Agan

  • Physician Assistant
  • Covington, WA
  • NPI 1134308380
  NPD (past)
• Richard O Avalon, D.O.

  • Family Medicine Physician
  • Renton, WA
  • NPI 1619930088
  NPD (past)
• Nicole Josefina Barrett, MSW, LICSW

  • Social Worker
  • Bellevue, WA
  • NPI 1902929862
  NPD (past)
• Gary Beerman, PA-C/ARNP

  • Family Nurse Practitioner
  • Kirkland, WA
  • NPI 1497855308
  NPD (past)
• Julie E Behrens, PSYD

  • Psychologist
  • Seattle, WA
  • NPI 1033158431
  NPD (past)
• Paul W Boone Jr., M.D.

  • Family Medicine Physician
  • Monroe, WA
  • NPI 1952342974
  NPD (past)
• Todd S. Bouchard, MD

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1942246418
  NPD (past)
• Paul Bowman, PA

  • Surgical Physician Assistant
  • Kirkland, WA
  • NPI 1467531533
  NPD (past)
• Kristen Beth Brown, ARNP

  • Family Nurse Practitioner
  • Renton, WA
  • NPI 1750569406
  NPD (past)
• Jennifer Beth Buchan, PA-C

  • Physician Assistant
  • Belfair, WA
  • NPI 1932299880
  NPD (past)
• Michael Francis Burke, MD

  • Surgery Physician
  • Renton, WA
  • NPI 1972574762
  NPD (past)
• Audrey Jean Church, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Issaquah, WA
  • NPI 1972683571
  NPD (past)

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1679862189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-917-6226",
            "fax_number": "425-917-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-917-6226",
            "fax_number": "425-917-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DISTRICT 1 OF KING COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "KENYON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY,AO",
        "authorized_official_telephone_number": "425-228-3440",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "WA",
            "license": "PHAR.CF.60213405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2013345",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2130796",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prescription Pad Pharmacy South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Public Hospital District #1 of King County
• Public Hospital District #1 of King County
• Public Hospital District #1 of King County
• Public Hospital District 1 of King County
• Public Hospital District 1 of King County
• Public Hospital District 1 of King County
• Public Hospital District#1 of King County
• Public Hospital Distrioct #1 of King County
• Andrena Pugh
• Sarah A Pullen, MD

• Institutional Pharmacy in Renton, WA
• Providers in Renton, WA by specialty
• Institutional Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.