NPIMap

Organization Active NPI

Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6

Doing business as Coulee Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Grand Coulee, WA
National Provider Identifier
1699851840
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
DOUGLAS, GRANT, LINCOLN & OKANOGAN COUNTIES PUBLIC HOSPITAL DISTRICT 6
Doing business as
Coulee Medical Center
Practice address
411 Fortuyn Rd
Grand Coulee, WA 99133-8718
Phone
(509) 633-1753
Fax
(509) 633-1933
NPI assigned
Oct 31, 2006
Last updated
Apr 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Authorized official

Name
Kelly Hughes
Title
Ceo
Phone
(509) 633-1753

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU Primary

Addresses

Primary practice location

411 Fortuyn Rd
Grand Coulee, WA 99133-8718

Mailing address

411 Fortuyn Rd
Grand Coulee, WA 99133-8718
Phone (509) 633-1753

Other identifiers 1

IdentifierTypeStateIssuer
4215018MedicaidWA

Other names 1

  • Coulee Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070914000409 WA Part A Provider - Critical Access Hospital 9335050285 Practice locations: Grand Coulee, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699851840. Details of each certification follow.

Hospital certification: CCN 50Z308

Legal name
DOUGLAS, GRANT, LINCOLN & OKANOGAN COUNTIES PUBLIC HOSPITAL DISTRICT 6
Doing business as
COULEE MEDICAL CENTER
Organization structure
OtherNon-profit
Enrollment address
411 Fortuyn Rd
Grand Coulee, WA 99133-8718
Hospital Swing-Bed Unit

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
Coulee Community Clinic22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

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
Ramona Hicks Individual Corporate OfficerCeo Feb 1, 2018
W-2 Managing EmployeeCeo Feb 1, 2018
Operational/Managerial ControlCeo Feb 1, 2018
Kelly Jean Hughes Individual Corporate OfficerCfo Jun 19, 2017
W-2 Managing EmployeeCfo Jun 19, 2017
Operational/Managerial ControlCfo Jun 19, 2017
Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 Organization, Grand Coulee, WA Non-profit Other Jan 1, 1990

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
Coulee Medical CenterGrand Coulee, WA, CCN 501308 Hospital Other Jan 1, 1990
Coulee Medical CenterCoulee City, WA, CCN 508535 Rural health clinic Other Feb 1, 1997
Coulee Family MedicineGrand Coulee, WA, CCN 503981 Rural health clinic Operational/Managerial Control Apr 29, 1992

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 55

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 55

Affiliated clinicians 4

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": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1699851840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 FORTUYN RD",
            "city": "GRAND COULEE",
            "state": "WA",
            "postal_code": "991338718",
            "telephone_number": "509-633-1753",
            "fax_number": "509-633-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 FORTUYN RD",
            "city": "GRAND COULEE",
            "state": "WA",
            "postal_code": "991338718",
            "telephone_number": "509-633-1753",
            "fax_number": "509-633-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS, GRANT, LINCOLN & OKANOGAN COUNTIES PUBLIC HOSPITAL DISTRICT 6",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-633-1753"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4215018",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coulee Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Coulee, WA

Sources for this page

Verify at the official NPI Registry.