NPIMap

Organization Active NPI

Prosser Public Hospital District of Benton County

Doing business as Prosser Women's Health CLinic

  • Multi-Specialty Clinic/Center
  • Prosser, WA
National Provider Identifier
1821556408
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY
Doing business as
Prosser Women's Health CLinic
Practice address
336 Chardonnay Ave BLDG 3
Prosser, WA 99350-9515
Phone
(509) 786-0031
Fax
(509) 786-0047
NPI assigned
Mar 4, 2019
Last updated
Mar 21, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Authorized official

Name
Craig Marks
Title
Ceo
Phone
(509) 786-2222

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Primary Care Clinic/Center 261QP2300X NU
Obstetrics & Gynecology Physician 207V00000X NU

Addresses

Primary practice location

336 Chardonnay Ave BLDG 3
Prosser, WA 99350-9515

Mailing address

723 Memorial St
Prosser, WA 99350-1524
Phone (509) 786-6681

Other names 1

  • Prosser Women's Health CLinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120000974 WA Part B Supplier - Clinic/Group Practice 6709787872 Receives reassigned benefits from 248 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Walla Walla, WA; Prosser, WA; Grandview, WA; Benton City, WA

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
50D2222910Prosser Women's Health Center336 Chardonnay Ave Ste B, Prosser, WA 99350Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Prosser Memorial Hosp E7 organizations share this tax ID, including this one
Part of
Prosser Memorial Hosp E

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553126400000",
    "number": "1821556408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 MEMORIAL ST",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993501524",
            "telephone_number": "509-786-6681",
            "fax_number": "509-786-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 CHARDONNAY AVE BLDG 3",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993509515",
            "telephone_number": "509-786-0031",
            "fax_number": "509-786-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY",
        "enumeration_date": "2019-03-04",
        "last_updated": "2019-03-21",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-786-2222"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prosser Women's Health CLinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prosser, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; 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.