NPIMap

Organization Active NPI

Kittitas Valley Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Yakima, WA
National Provider Identifier
1740906551
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
KITTITAS VALLEY URGENT CARE, PLLC
Practice address
1006 S 64TH Ave Ste 100
Yakima, WA 98908-2090
Phone
(509) 955-9248
Fax
(509) 955-8248
NPI assigned
Oct 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Authorized official

Name
Paul David Wood, PA-CNPI 1306857149
Title
Owner
Phone
(509) 899-6179

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1006 S 64TH Ave Ste 100
Yakima, WA 98908-2090

Mailing address

1006 S 64TH Ave Ste 100
Yakima, WA 98908-2090
Phone (509) 955-9248

Other names 1

  • Yakima Valley Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230508000684 WA DME Supplier - Multi-Specialty - Physician 5092093542 Practice locations: Yakima, WA

Other NPIs with the same Medicare PAC ID 2

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

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
50D2181846Yakima Valley Urgent Care1006 S 64TH Ave Ste 100, Yakima, WA 98908Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Kittitas Valley Urgent Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1740906551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 S 64TH AVE STE 100",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989082090",
            "telephone_number": "509-955-9248",
            "fax_number": "509-955-8248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 S 64TH AVE STE 100",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989082090",
            "telephone_number": "509-955-9248",
            "fax_number": "509-955-8248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITTITAS VALLEY URGENT CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-899-6179",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yakima Valley Urgent Care",
            "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 Oct 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.