Kittitas County Public Hospital Dist 1
Organization Active NPI Rural Health Clinic/Center · Ellensburg, WA
NPI 1932115391 · NPPES record last updated Jul 29, 2026
Key facts
- NPI
- 1932115391
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- KITTITAS COUNTY PUBLIC HOSPITAL DIST 1
- Practice address
- 603 S Chestnut St
Ellensburg, WA 98926-3875 - Phone
- (509) 925-8445
- Fax
- (509) 925-8464
- NPI assigned
- Jul 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Lisa Gott
- Title
- Director Revenue Cycle Operations
- Phone
- (509) 962-7424
Owners & managing parties with NPI records 6
Owned or controlled facilities with NPI records 6
Other NPIs on the same Medicare enrollment 8
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 15
Related certifications (CCN) 1
Facilities with the same owner 6
Practitioners 122
-
Jay K Callarman, D.P.M.
-
Anna Collins, ARNP
-
Jamin Feng, MD
-
Berhan Ghermay, M.D.
-
Mary C. Nouwens, ARNP
-
Alisa L Peterson, LICSW
-
Shawn E Rogers, M.D.
-
Anita Cecelia Schiltz, ARNP
-
Erin See, NP
-
Michelle K Smeback, ARNP
-
Wendy L Bridger, FNP
-
Michael Zammit, M.D.
-
Katie Bates, ARNP
-
Hope Michelle Pike Beam, APRN
-
John Mark Beard, MD
-
Kelly Behne, PA-C
-
Zoe Christina Birt, PA-C
-
Jennifer Bryan, DO
-
Stuart B Cardon, DPM
-
Cierra Delay, DO
-
Jose Angel Diaz, PA C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WA
Rural health clinic certification: CCN 508545
- Legal name
- KITTITAS COUNTY PUBLIC HOSPITAL DIST 1
- Doing business as
- KITTITAS VALLEY HEALTHCARE INTERNAL MEDICINE
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Oct 11, 2007
- Last certification
- May 28, 2014
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Incorporated
- Sep 11, 2009 in WA
- Enrollment address
- 700 E Manitoba Ave
Ellensburg, WA 98926-3885 - Related CCNs
- 501333
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Lisa Gott |
W-2 Managing Employee |
Jan 1, 2023 | |
| Kittitas County Public Hospital Dist 1 |
Operational/Managerial Control | Jul 26, 2007 | 100% |
| Jason Adler |
Corporate Officer |
Dec 15, 2024 | |
| W-2 Managing Employee |
Dec 15, 2024 |
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Kittitas Valley Healthcare |
Hospital | Operational/Managerial Control (100%) | Jan 1, 1966 |
| Kittitas Valley Healthcare |
Hospital | Operational/Managerial Control (100%) | Jan 1, 2004 |
| Kittitas Valley Healthcare Home Health |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 1, 1964 Jan 1, 1964 |
| Kittitas Valley Comm Hospital Hospice |
Hospice | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Jul 25, 2008 Oct 3, 2011 |
| Kittitas Valley Healthcare Family Medicine Cle Elum |
Rural health clinic | Operational/Managerial Control (100%) | Jul 1, 2005 |
| Medical Arts Center Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Nov 1, 1966 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040213000046 | WA | Part B Supplier - Clinic/Group Practice | 0547179608 |
Receives reassigned benefits from 176 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Ellensburg, WA; Cle Elum, WA |
| O20070912000895 | WA | Part a Provider - Rural Health Clinic | 0547179608 | Practice locations: Ellensburg, WA |
National Provider Directory
- Tax ID family
- Kittitas County Public Hospital District 1
Locations
700 E Manitoba Ave
Ste 101
Ellensburg, WA 98926
Phone (509) 452-5378
Interoperability endpoints
- djackson@kittitasvalleyhealthcare.cernerdirect.com
- mnouwens@kittitasvalleyhealthcare.cernerdirect.com
- soldenkamp@kittitasvalleyhealthcare.cernerdirect.com
- kvhgeriatricserv@kittitasvalleyhealthcare.cernerdirect.com
- aschock@kittitasvalleyhealthcare.cernerdirect.com
- jfeng@kittitasvalleyhealthcare.cernerdirect.com
- acollins@kittitasvalleyhealthcare.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | H 140 | WA | |
| Rural Health Clinic/Center | 261QR1300X | WA | Yes |
Addresses
Primary practice location
603 S Chestnut St
Ellensburg, WA 98926-3875
Mailing address
PO Box 799
Ellensburg, WA 98926-1921
Phone (509) 933-8771
Other practice location 1
603 S Chestnut St
Ellensburg, WA 98926-3875
Phone (509) 962-6100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7120595 | Medicaid | WA | |
| 152 | Other | WA | BLUE CROSS |
| 0202873 | Other | WA | LABOR & INDUST |
Other names
- KVH Internal Medicine
Other providers in Ellensburg, WA
- Kittitas County Public Hospital Dist 1
- Kittitas County Public Hospital Dist 1
- Kittitas County Public Hospital Dist 1
- Kittitas County Public Hospital Dist 1
- Kittitas County Public Hospital Dist 1
- Kittitas County Public Hospital Dist 1
- Kittitas County Public Hospital District
- Kittitas County Public Hospital District #1
- Kittitas County Public Hospital District #1
- Kittitas County Public Hospital District #1
All providers in Ellensburg, WA · Rural Health Clinic/Center in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.