NPIMap

Organization Active NPI

Iron Bridge Healthcare, Inc.

Doing business as Columbia River Home Health

  • Home Health Agency
  • Kennewick, WA
National Provider Identifier
1699263079
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
IRON BRIDGE HEALTHCARE, INC.
Doing business as
Columbia River Home Health
Practice address
7105 W Hood PL Ste B201
Kennewick, WA 99336-6714
Phone
(509) 591-4459
NPI assigned
May 1, 2018
Last updated
Mar 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Authorized official

Name
Lee Johnson
Title
Treasurer
Phone
(208) 401-1369

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

7105 W Hood PL Ste B201
Kennewick, WA 99336-6714

Mailing address

7105 W Hood PL Ste B201
Kennewick, WA 99336-6714
Phone (509) 591-4459

Other names 1

  • Columbia River Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180809004345 WA Part A Provider - Home Health Agency 0547518458 Practice locations: Kennewick, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699263079. Details of each certification follow.

Home health agency certification: CCN 507061

Legal name
IRON BRIDGE HEALTHCARE INC
Doing business as
COLUMBIA RIVER HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 10, 1985
Last certification
Jul 16, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 27, 2018 in NV
Enrollment address
7105 W Hood PL
Ste B201
Kennewick, WA 99336-6714
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Columbia River Home HealthCCN 507061 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Apr 10, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, 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
50D0876453Columbia River Home Health7105 W Hood PL Ste B201, Kennewick, WA 99336Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

7105 W Hood Pl
Ste B201
Kennewick, WA 99336
Phone (509) 591-4459

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Eric Wise Individual W-2 Managing EmployeeAdministrator Jul 1, 2019
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Direct Ownership Interest Jul 1, 2018 100%
Brent Mills Individual Corporate OfficerTreasurer Apr 6, 2026
Brent Guerisoli Individual Corporate DirectorDirector and Sole Board Member Mar 5, 2023
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2019 100%
John J Gochnour Individual Corporate OfficerPresident Apr 3, 2024
Amber Tueller Individual Corporate OfficerSecretary Apr 3, 2024

Facilities with the same owner 141

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

View all 141

Practitioners & affiliated clinicians

Affiliated clinicians 95

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

View all 95

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1699263079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7105 W HOOD PL STE B201",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366714",
            "telephone_number": "509-591-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7105 W HOOD PL STE B201",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366714",
            "telephone_number": "509-591-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRON BRIDGE HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-01",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "208-401-1369"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia River Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.