NPIMap

Organization Active NPI

Tri-Cities Community Health

  • Federally Qualified Health Center (FQHC)
  • Kennewick, WA
National Provider Identifier
1861698987
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TRI-CITIES COMMUNITY HEALTH
Practice address
3180 W Clearwater Ave Ste a
Kennewick, WA 99336
Phone
(509) 547-2204
NPI assigned
Jun 25, 2007
Last updated
Jan 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Authorized official

Name
Kristy Needham
Title
Ceo
Phone
(509) 547-2204

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Geriatric Medicine (Internal Medicine) Physician 207RG0300X
Obstetrics & Gynecology Physician 207V00000X
Pediatrics Physician 208000000X

Addresses

Primary practice location

3180 W Clearwater Ave Ste a
Kennewick, WA 99336

Mailing address

PO Box 1452
Pasco, WA 99301-1223
Phone (509) 547-2204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040203000209 WA Part B Supplier - Clinic/Group Practice 4183517469 Receives reassigned benefits from 43 practitioners
5 other NPIs on this enrollment
Practice locations: Pasco, WA; Richland, WA; Mesa, WA; Kennewick, WA
O20061012000683 WA Part A Provider - Federally Qualified Health Center (FQHC) 4183517469 1 other NPI on this enrollment
Practice locations: Kennewick, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861698987. Details of each certification follow.

Federally qualified health center certification: CCN 501901

Legal name
TRI-CITIES COMMUNITY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 1, 2006
Last certification
Dec 1, 2006
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 3, 1996 in WA
Enrollment address
3180 W Clearwater Ave
Ste a
Kennewick, WA 99336-2765

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Amanda L Lang Individual Corporate DirectorAssociate Medical Director Oct 1, 2018
W-2 Managing EmployeeAssociate Medical Director Oct 1, 2018
Kristy Needham Individual Corporate OfficerChief Operating Officer Feb 1, 2022
James M Merrill Individual Corporate OfficerChief Executive Officer May 20, 2019
Alexandria Glasenapp Individual Corporate DirectorBilling Manager Mar 10, 2022
Ana M Ruiz Peralta Individual Corporate OfficerBoard Chair Nov 29, 2018
Kristine Taggares Individual Corporate OfficerBoard Sergeant of Arms Sep 1, 2019
Jeanne S McPherson Individual Corporate OfficerBoard Vice Chair Sep 1, 2018

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 44

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 44

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1861698987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1452",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993011223",
            "telephone_number": "509-547-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 W CLEARWATER AVE STE A",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "99336",
            "telephone_number": "509-547-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITIES COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "NEEDHAM",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-547-2204"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.