NPIMap

Organization Active NPI

Pend Oreille County Public Hospital District No 1

Doing business as Newport Health Center

  • Rural Health Clinic/Center
  • Newport, WA
National Provider Identifier
1912026360
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
264000780 Issued in WA
Legal business name
PEND OREILLE COUNTY PUBLIC HOSPITAL DISTRICT NO 1
Doing business as
Newport Health Center
Practice address
714 W Pine St
Newport, WA 99156-9046
Phone
(509) 447-3139
Fax
(509) 447-0456
NPI assigned
Mar 28, 2007
Last updated
Sep 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Authorized official

Name
Kim M Manus
Title
Ceo
Phone
(509) 447-9310

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 264000780 WA Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

714 W Pine St
Newport, WA 99156-9046

Mailing address

714 W Pine St
Newport, WA 99156-9046
Phone (509) 447-3139

Other identifiers 3

IdentifierTypeStateIssuer
7105455MedicaidWA
7098395MedicaidWA
805262500MedicaidID

Other names 1

  • Newport Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050706000270 WA Part A Provider - Rural Health Clinic 3274431184 Practice locations: Newport, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912026360. Details of each certification follow.

Rural health clinic certification: CCN 508500

Legal name
PEND OREILLE COUNTY PUBLIC HOSPITAL DISTRICT NO 1
Doing business as
NEWPORT HEALTH CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 9, 1997
Last certification
Aug 5, 2015
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
714 W Pine St
BLDG C
Newport, WA 99156-9046
Related CCNs
501310

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Richard N Mattis MD7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Susan Johnson Individual Corporate DirectorBoard Member Jan 1, 2020
Melanie Endicott Individual Corporate DirectorBoard Commissioner Nov 10, 2021
Lois Robertson Individual Corporate DirectorBoard Member Jun 23, 2011
Becky Walrath Individual Corporate DirectorBoard Commissioner Nov 17, 2021
Pend Oreille County Public Hospital District No 1 Organization, Newport, WA Operational/Managerial Control Jul 1, 1966
Mary Elswick Individual Corporate DirectorBoard Commissioner Nov 4, 2009
Justin Peters Individual W-2 Managing EmployeeCfo May 12, 2025
Kim Manus Individual W-2 Managing EmployeeAd; Jul 6, 2005

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Newport Community HospitalNewport, WA, CCN 501310 Hospital Operational/Managerial Control (100%) Jan 1, 1966
Newport Community HospitalNewport, WA, CCN 50Z310 Hospital Operational/Managerial Control (100%) Jul 1, 1966

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757462400000",
    "number": "1912026360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 W PINE ST",
            "city": "NEWPORT",
            "state": "WA",
            "postal_code": "991569046",
            "telephone_number": "509-447-3139",
            "fax_number": "509-447-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W PINE ST",
            "city": "NEWPORT",
            "state": "WA",
            "postal_code": "991569046",
            "telephone_number": "509-447-3139",
            "fax_number": "509-447-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEND OREILLE COUNTY PUBLIC HOSPITAL DISTRICT NO 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A",
        "authorized_official_last_name": "MANUS",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-447-9310"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WA",
            "license": "264000780",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7105455",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7098395",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805262500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newport Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport, WA

Sources for this page

Verify at the official NPI Registry.