NPIMap

Organization Active NPI

North Central Washington Health LLC

Doing business as Mansfield Family Medicine

  • Primary Care Clinic/Center
  • Soap Lake, WA
National Provider Identifier
1790021822
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
PA10004217 Issued in WA
Legal business name
NORTH CENTRAL WASHINGTON HEALTH LLC
Doing business as
Mansfield Family Medicine
Practice address
22 West Highway 28
Soap Lake, WA 98851
Phone
(509) 888-9606
Fax
(509) 246-8001
NPI assigned
Dec 18, 2012
Last updated
May 24, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Authorized official

Name
Mr. Eldon Lester Leinweber, PA-CNPI 1730148958
Title
Ceo, Manager
Phone
(509) 881-7503

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X PA10004217 WA Primary

Addresses

Primary practice location

22 West Highway 28
Soap Lake, WA 98851

Mailing address

PO Box 1050
Soap Lake, WA 98851-1050
Phone (509) 888-9606

Other identifiers 2

IdentifierTypeStateIssuer
8418451MedicaidWA
Q59925OtherWAUPIN

Other names 1

  • Mansfield Family Medicine Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1355788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1790021822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1050",
            "city": "SOAP LAKE",
            "state": "WA",
            "postal_code": "988511050",
            "telephone_number": "509-888-9606",
            "fax_number": "509-246-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 WEST HIGHWAY 28",
            "city": "SOAP LAKE",
            "state": "WA",
            "postal_code": "98851",
            "telephone_number": "509-888-9606",
            "fax_number": "509-246-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CENTRAL WASHINGTON HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-18",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "LEINWEBER",
        "authorized_official_first_name": "ELDON",
        "authorized_official_middle_name": "LESTER",
        "authorized_official_title_or_position": "CEO, MANAGER",
        "authorized_official_telephone_number": "509-881-7503",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": "PA10004217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8418451",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "Q59925",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mansfield Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Soap Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.