NPIMap

Organization Active NPI

Whidbey Island Public Hospital District

  • Critical Access Hospital
  • Coupeville, WA
National Provider Identifier
1710927231
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
00000156 Issued in WA
Legal business name
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Practice address
101 N Main St
Coupeville, WA 98239-3413
Phone
(360) 678-5151
Fax
(360) 678-7676
NPI assigned
Jun 7, 2006
Last updated
Jul 20, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Authorized official

Name
Garth A MillerNPI 1801082102
Title
Coo
Phone
(360) 678-7656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X WA
Medicare Defined Swing Bed Hospital Unit 275N00000X
Critical Access Hospital 282NC0060X 000092 WA
Critical Access Hospital 282NC0060X 00000156 WA Primary
Ambulance 341600000X
Emergency Medicine Physician 207P00000X
Sleep Medicine (Internal Medicine) Physician 207RS0012X

Addresses

Primary practice location

101 N Main St
Coupeville, WA 98239-3413

Mailing address

PO Box 3603
Seattle, WA 98124-3603
Phone (360) 678-5151

Other identifiers 2

IdentifierTypeStateIssuer
1017139MedicaidWA
3310000MedicaidWA

Other names 1

  • WhidbeyHealth Medical Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NY, CA, AK, FL, ID, NV, ND10 enrollments

Enrollment records 10

Enrollment IDStateProvider typePAC IDDetails
O20040210000761 WA Part B Supplier - Clinic/Group Practice 1658280680 Receives reassigned benefits from 136 practitioners
17 other NPIs on this enrollment
O20071105000513 WA Part A Provider - Critical Access Hospital 1658280680 Receives reassigned benefits from 55 practitioners
5 other NPIs on this enrollment
Practice locations: Clinton, WA; Coupeville, WA; Oak Harbor, WA
O20170407001679 NY Part B Supplier - Clinic/Group Practice 1658280680 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New York, NY; South Setauket, NY
O20170501000821 CA Part B Supplier - Clinic/Group Practice 1658280680 Receives reassigned benefits from 3 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Desert Hot Springs, CA; Irvine, CA; Mountain View, CA
O20190718000818 WA Part A Provider - Critical Access Hospital 1658280680 Practice locations: Coupeville, WA
O20200507002051 AK Part B Supplier - Clinic/Group Practice 1658280680 Receives reassigned benefits from 24 practitioners
3 other NPIs on this enrollment
Practice locations: Soldotna, AK; Fairbanks, AK; Fort Wainwright, AK
O20240912001060 FL Part B Supplier - Clinic/Group Practice 1658280680 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sarasota, FL; Fort Pierce, FL
O20240923004148 ID Part B Supplier - Clinic/Group Practice 1658280680 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Lewiston, ID
O20250120000196 NV Part B Supplier - Clinic/Group Practice 1658280680 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Henderson, NV; Las Vegas, NV
O20251124001760 ND Part B Supplier - Clinic/Group Practice 1658280680 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mandan, ND

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1710927231. Details of each certification follow.

Hospital certification: CCN 501339

Legal name
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Doing business as
WHIDBEYHEALTH MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 31, 2005
Last certification
Jul 22, 2020
Beds
51
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Enrollment address
101 N Main St
Coupeville, WA 98239-3413
Main/Primary Hospital Location

Hospital certification: CCN 50Z339

Legal name
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Doing business as
WHIDBEYHEALTH MEDICAL CENTER
Organization structure
OtherNon-profit
Enrollment address
101 N Main St
Coupeville, WA 98239-3413
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 12

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

Other NPIs on the same Medicare enrollment 33

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

View all 33

Care Compare: Hospital

Medicare Care Compare
Listed as
Whidbeyhealth Medical CenterCCN 501339 · All quality measures
Overall star rating
2 of 5
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
50D0634376Whidbeyhealth Medical Center Laboratory101 N Main St, Coupeville, WA 98239AccreditationApr 4, 2028

National Provider Directory

National Provider Directory
Part of
Whidbey Island Pub Hospital

Member of 1

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

Locations

1255 Raritan Rd
Unit F4B
Clark, NJ 07066

6400 SE Lake Rd
Portland, OR 97222
Phone (503) 594-1774

1300 NE Goldie St
Slp Care
Oak Harbor, WA 98277
Phone (360) 240-4082

Interoperability endpoints

  • Direct secure messaging: dubled@direct.whidbeygen.org
  • Direct secure messaging: hanseb@direct.whidbeygen.org
  • Direct secure messaging: jollec@direct.whidbeygen.org
  • Direct secure messaging: lhamoh@direct.whidbeygen.org
  • Direct secure messaging: mahalm@direct.whidbeygen.org
  • Direct secure messaging: mckeed@direct.whidbeygen.org
  • Direct secure messaging: montgt@direct.whidbeygen.org
  • Direct secure messaging: perern@direct.whidbeygen.org
  • Direct secure messaging: phelpz@direct.whidbeygen.org
  • Direct secure messaging: plastij@direct.whidbeygen.org
  • Direct secure messaging: ranger@direct.whidbeygen.org
  • Direct secure messaging: reidll@direct.whidbeygen.org
  • Direct secure messaging: shermj@direct.whidbeygen.org
  • Direct secure messaging: thorel@direct.whidbeygen.org
  • Direct secure messaging: wongde@direct.whidbeygen.org
  • Direct secure messaging: yankem@direct.whidbeygen.org

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Whidbey Island Public Hospital District Organization, Coupeville, WA 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
5% Or Greater Direct Ownership Interest Jan 1, 1966
Curtis Andrew Shumate Individual Corporate DirectorExecutive Director of Nursing Feb 1, 2022
W-2 Managing Employee Feb 22, 2010
Corporate OfficerExecutive Director of Nursing Feb 1, 2022
W-2 Managing EmployeeRN Feb 22, 2010
Kirk P Gasper Individual Corporate OfficerCommissioner Dec 2, 2025
Corporate DirectorCommissioner Dec 2, 2025
Corporate Officer Dec 2, 2025
Corporate Director Dec 2, 2025
Garth a Miller Individual Corporate OfficerChief Operations Officer Sep 23, 2021
Corporate DirectorChief Operations Officer Sep 23, 2021
W-2 Managing Employee Aug 1, 2018
James Dean Golder Individual Corporate Officer Jan 1, 2022
Corporate Director Jan 1, 2022
Corporate OfficerCommissioner Jan 1, 2022
Corporate DirectorCommissioner Jan 1, 2022
Mark Ethan Borden Individual Corporate OfficerCommissioner Jan 1, 2026
Corporate DirectorCommissioner Jan 1, 2026
Marion Louise Jouas Individual Corporate DirectorCommissioner Dec 14, 2023
Corporate OfficerCommissioner Dec 14, 2023
Jamie Canby Individual Corporate OfficerCommissioner Jan 1, 2026
Corporate DirectorCommissioner Jan 1, 2026
Paul Rogers Individual Corporate OfficerInterim Cfo Sep 16, 2022
Corporate DirectorInterim Cfo Sep 16, 2022
Corporate OfficerCfo Sep 16, 2022
Corporate DirectorCfo Sep 16, 2022
W-2 Managing Employee Sep 16, 2022
Nathan Staggs Individual Corporate OfficerCeo Mar 22, 2023
Corporate DirectorCeo Mar 22, 2023
W-2 Managing EmployeeCeo Mar 22, 2023
W-2 Managing Employee Mar 22, 2023

Owners & managing parties with NPI records 12

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Whidbeyhealth Hospice CareCoupeville, WA, CCN 501542 Hospice 5% Or Greater Direct Ownership Interest (100%) Jan 30, 2013
Whidbeyhealth Primary Care - Goldie St.Oak Harbor, WA, CCN 503996 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 1, 1962
Jan 1, 1962
Whidbeyhealth Primary Care - ClintonClinton, WA, CCN 508506 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 1, 1962
Jan 1, 1962
Whidbeyhealth Primary Care - FreelandFreeland, WA, CCN 508585 Rural health clinic Other (100%) Apr 1, 1969
Whidbeyhealth Primary Care - CabotOak Harbor, WA, CCN 508584 Rural health clinic Other Apr 1, 2011
Whidbeyhealth Primary Care - CoupevilleCoupeville, WA, CCN 508583 Rural health clinic Other (100%) Apr 1, 1969

Owned or controlled facilities with NPI records 12

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 177

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 177

Affiliated clinicians 336

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

View all 336

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1710927231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3603",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243603",
            "telephone_number": "360-678-5151",
            "fax_number": "360-678-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N MAIN ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982393413",
            "telephone_number": "360-678-5151",
            "fax_number": "360-678-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "enumeration_date": "2006-06-07",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GARTH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "360-678-7656"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WA",
            "license": "000092",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WA",
            "license": "00000156",
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017139",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3310000",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WhidbeyHealth Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Coupeville, WA

Sources for this page

Verify at the official NPI Registry.