NPIMap

Individual provider Active NPI

Chad A Mongrain, DO

  • Family Medicine Physician
  • Davenport, WA
National Provider Identifier
1720028244
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP00002086 Issued in WA
Practice address
10 Nicholls St
Davenport, WA 99122-9729
Phone
(509) 725-7501
Fax
(509) 725-7504
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP00002086 WA Primary

Addresses

Primary practice location

10 Nicholls St
Davenport, WA 99122-9729

Mailing address

10 Nicholls St
Davenport, WA 99122-9729
Phone (509) 725-7501

Other identifiers 3

IdentifierTypeStateIssuer
1017260MedicaidWA
AB06402OtherWAGROUP MEDICARE PIN
8452310MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060623000244 WA Practitioner - Family Practice 0840202453 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lincoln County Hospital District 3Group PAC ID 3971591199, shared by 5 NPIs, 21 clinicians

Practice addresses (Care Compare)

10 Nicholls St
Davenport, WA 99122-9729

10 Nicholls St
Clinic
Davenport, WA 99122-9730
Phone (509) 725-7501

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln County Hospital District 3 Family Medicine Current Accepting new patients
Lincoln County Hospital District #3 CurrentSince Nov 26, 2018 Accepting new patients
Lincoln County Hospital District 3 CurrentSince Nov 26, 2018 Accepting new patients
Lincoln County Hospital District #3 Family Medicine CurrentSince Nov 26, 2018 Accepting new patients
Our Lady of Lourdes Health Center Past Accepting new patients
Our Lady of Lourdes Health Center Family Medicine Past Accepting new patients
Inland Empire Hospital Services Association Family Medicine Past Accepting new patients
Lourdes Hospital LLC Past Accepting new patients
Our Lady of Lourdes Health Center Past Accepting new patients
Our Lady of Lourdes Hospital at Pasco Past Accepting new patients

Locations

100 3rd St
Ste 1
Davenport, WA 99122
Phone (509) 725-7501

10 Nicholls St
Davenport, WA 99122
Phone (509) 725-7101

Interoperability endpoints

  • Direct secure messaging: cmongrain975699@wm.providencedirect.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1720028244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 NICHOLLS ST",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991229729",
            "telephone_number": "509-725-7501",
            "fax_number": "509-725-7504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 NICHOLLS ST",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991229729",
            "telephone_number": "509-725-7501",
            "fax_number": "509-725-7504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGRAIN",
        "first_name": "CHAD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00002086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017260",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PIN",
            "identifier": "AB06402",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8452310",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, WA

Sources for this page

Verify at the official NPI Registry.