NPIMap

Organization Active NPI

Peninsula Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Bremerton, WA
National Provider Identifier
1811630767
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PENINSULA COMMUNITY HEALTH SERVICES
Practice address
7077 Stampede Blvd NW RM 14
Bremerton, WA 98311-8954
Phone
(360) 377-3776
NPI assigned
Apr 19, 2022
Last updated
May 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Authorized official

Name
Jennifer Kreidler-MossNPI 1194839761
Title
Ceo
Phone
(360) 377-3776

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 8

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Case Management Agency 251B00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

7077 Stampede Blvd NW RM 14
Bremerton, WA 98311-8954

Mailing address

PO Box 960
Bremerton, WA 98337-0212

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221216001097 WA Part A Provider - Federally Qualified Health Center (FQHC) 9436044781 Practice locations: Bremerton, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811630767. Details of each certification follow.

Federally qualified health center certification: CCN 501016

Legal name
PENINSULA COMMUNITY HEALTH SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 14, 2022
Last certification
Nov 14, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 22, 1999 in WA
Enrollment address
7077 Stampede Blvd NW RM Prtbleh14
Bremerton, WA 98311-8954

National Provider Directory

National Provider Directory
Tax ID family
Peninsula Community51 organizations share this tax ID, including this one
Part of
Peninsula Community

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Locations

7077 Stampede Blvd NW
#H
Bremerton, WA 98311

7077 Stampede Blvd NW
Rm 14
Bremerton, WA 98311

7077 Stampede Blvd NW
Rm 13
Bremerton, WA 98311

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Christopher J Cook Individual Corporate DirectorDirector Jun 1, 2006
Jennifer Kreidler-Moss Individual Corporate OfficerCeo Aug 1, 2015
W-2 Managing EmployeeCeo Aug 1, 2015
Operational/Managerial ControlCeo Aug 1, 2015
Susan Astle Individual Corporate DirectorDirector Dec 1, 2017
Monica Bernhard Individual Corporate DirectorDirector Apr 1, 2009
Yolanda N Fong Individual Corporate Director Sep 18, 2024
Neal Schanbeck Individual Corporate DirectorCommunity Member Dec 17, 2025
Lolita Afalla Individual Corporate Director Sep 18, 2024
Leslie Jackson Individual Corporate DirectorPatient Member Nov 19, 2025
Mary Berglind Individual Corporate Director Feb 1, 2023
Kristin Lillegard Individual Corporate DirectorCommunity Member Feb 18, 2026
Alfred D Pinkham Individual Corporate DirectorDirector Nov 1, 2015
Mary Dixon Individual Corporate DirectorPatient Member Aug 20, 2025
David Windom Individual Corporate DirectorDirector Dec 1, 2019
Peninsula Community Health Services Organization, Bremerton, WA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Aug 23, 2022
Rogelio Valencia Individual Corporate Director Feb 1, 2023
Shannon Turner Individual Corporate Director May 21, 2025

All facility ownership & control disclosures 26

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

FacilityTypeRoleSince
Kitsap Community Health CentersPort Orchard, WA, CCN 501923 Federally qualified health center Operational/Managerial Control Jan 1, 2016
Peninsula Community Health ServicesBremerton, WA, CCN 501924 Federally qualified health center Operational/Managerial Control Jan 1, 2016
Peninsula Community Health ServicesBremerton, WA, CCN 941011 Federally qualified health center Operational/Managerial Control Jan 1, 2016
Peninsula Community Health Services BelfairBelfair, WA, CCN 941032 Federally qualified health center Operational/Managerial Control Apr 1, 2017
Peninsula Community Health Services KingstonKingston, WA, CCN 941033 Federally qualified health center Operational/Managerial Control May 1, 2017
Peninsula Community Health ServicesShelton, WA, CCN 941044 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2019
Peninsula Community Health ServicesBremerton, WA, CCN 941061 Federally qualified health center Operational/Managerial Control Sep 3, 2019
Peninsula Community Health ServicesBremerton, WA, CCN 941059 Federally qualified health center Operational/Managerial Control Sep 3, 2019
Peninsula Community Health ServicesBelfair, WA, CCN 941060 Federally qualified health center Operational/Managerial Control (100%) Sep 3, 2019
Peninsula Community Health ServicesBremerton, WA, CCN 941064 Federally qualified health center Operational/Managerial Control (100%) Sep 3, 2019
Peninsula Community Health ServicesSilverdale, WA, CCN 941070 Federally qualified health center Operational/Managerial Control May 1, 2020
Peninsula Community Health ServicesBremerton, WA, CCN 941074 Federally qualified health center Operational/Managerial Control (100%) Apr 20, 2020
Peninsula Community Health ServicesGig Harbor, WA, CCN 501005 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 17, 2021
Nov 17, 2021
Peninsula Community Health ServicesBremerton, WA, CCN 501006 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 31, 2022
May 31, 2022
Peninsula Community Health ServicesBremerton, WA, CCN 501010 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Sep 16, 2022
Sep 16, 2022
Peninsula Community Health ServicesPort Orchard, WA, CCN 501007 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Sep 24, 2021
Sep 24, 2021
Peninsula Community Health ServicesBremerton, WA, CCN 501008 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Oct 1, 2021
Oct 1, 2021
Peninsula Community Health ServicesKingston, WA, CCN 501013 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Apr 14, 2022
Apr 14, 2022
Peninsula Community Health ServicesBremerton, WA, CCN 501012 Federally qualified health center 5% Or Greater Direct Ownership Interest Apr 14, 2022
Peninsula Community Health ServicesSilverdale, WA, CCN 501015 Federally qualified health center 5% Or Greater Direct Ownership Interest Sep 24, 2021
Peninsula Community Health ServicesSilverdale, WA, CCN 501037 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Sep 8, 2023
Sep 8, 2023
Peninsula Community Health ServicesSilverdale, WA, CCN 501035 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Sep 8, 2023
Sep 8, 2023
Peninsula Community Health ServicesPoulsbo, WA, CCN 501038 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Nov 1, 2023
Nov 1, 2023
Peninsula Community Health ServicesPort Orchard, WA, CCN 501067 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 5, 2025
Peninsula Community Health ServicesPoulsbo, WA, CCN 501068 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jun 1, 2025
Jun 1, 2025
Peninsula Community Health ServicesBainbridge Island, WA, CCN 501079 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 12, 2026
Jan 12, 2026

Facilities with the same owner 26

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

View all 26

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": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1811630767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 960",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983370212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7077 STAMPEDE BLVD NW RM 14",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983118954",
            "telephone_number": "360-377-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA COMMUNITY HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-19",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "KREIDLER-MOSS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-377-3776"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.