NPIMap

Organization Active NPI

Sunnyside Community Hospital Association

Doing business as Central Valley Vascular Center

  • Vascular Surgery Physician
  • Yakima, WA
National Provider Identifier
1710496922
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION
Doing business as
Central Valley Vascular Center
Practice address
1005 W Walnut St Ste 201
Yakima, WA 98902-3384
Phone
(509) 454-6545
Fax
(509) 454-6544
NPI assigned
Sep 20, 2017
Last updated
Feb 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Authorized official

Name
Mr. Cary Rowan
Title
Cfo
Phone
(509) 837-1356

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X Primary

Addresses

Primary practice location

1005 W Walnut St Ste 201
Yakima, WA 98902-3384

Mailing address

PO Box 719
Sunnyside, WA 98944-0719

Other names 1

  • Central Valley Vascular Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040227000194 WA Part B Supplier - Clinic/Group Practice 1658280896 Receives reassigned benefits from 139 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Zillah, WA; Yakima, WA; Union Gap, WA; Toppenish, WA; Sunnyside, WA; Prosser, WA; Grandview, WA

Other NPIs on the same Medicare enrollment 30

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 30

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

803 E Lincoln Ave
Ste C
Sunnyside, WA 98944

812 Miller Ave
Sunnyside, WA 98944
Phone (509) 836-4825

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549238400000",
    "number": "1710496922",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 W WALNUT ST STE 201",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023384",
            "telephone_number": "509-454-6545",
            "fax_number": "509-454-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2019-02-04",
        "status": "A",
        "authorized_official_last_name": "ROWAN",
        "authorized_official_first_name": "CARY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "509-837-1356",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Valley Vascular Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.