NPIMap

Organization Active NPI

Walla Walla General Hospital

  • General Acute Care Hospital
  • Walla Walla, WA
National Provider Identifier
1760466114
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
HAC.FS.00000043 Issued in WA
Legal business name
WALLA WALLA GENERAL HOSPITAL
Practice address
1025 S 2ND Ave
Walla Walla, WA 99362-4116
Phone
(509) 525-0480
Fax
(509) 527-8159
NPI assigned
Nov 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Authorized official

Name
Mr. Rick D Bockmann
Title
Ceo
Phone
(509) 525-0480

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
General Acute Care Hospital 282N00000X HAC.FS.00000043 WA Primary

Addresses

Primary practice location

1025 S 2ND Ave
Walla Walla, WA 99362-4116

Mailing address

PO Box 1398
Walla Walla, WA 99362-0309
Phone (509) 525-0480

Other identifiers 2

IdentifierTypeStateIssuer
208850MedicaidOR
1018337MedicaidWA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1760466114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1398",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993620309",
            "telephone_number": "509-525-0480",
            "fax_number": "509-527-8159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S 2ND AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624116",
            "telephone_number": "509-525-0480",
            "fax_number": "509-527-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLA WALLA GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "BOCKMANN",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-525-0480",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WA",
            "license": "HAC.FS.00000043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208850",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018337",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.