NPIMap

Organization Active NPI

Kittitas County Public Hospital Dist 1

Doing business as KVH Internal Medicine

  • Rural Health Clinic/Center
  • Ellensburg, WA
National Provider Identifier
1932115391
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
KITTITAS COUNTY PUBLIC HOSPITAL DIST 1
Doing business as
KVH Internal Medicine
Practice address
603 S Chestnut St
Ellensburg, WA 98926-3875
Phone
(509) 925-8445
Fax
(509) 925-8464
NPI assigned
Jul 31, 2006
Last updated
Jul 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Authorized official

Name
Lisa Gott
Title
Director Revenue Cycle Operations
Phone
(509) 962-7424

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X WA Primary
Specialist 174400000X H 140 WA

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 3

IdentifierTypeStateIssuer
0202873OtherWALABOR & INDUST
152OtherWABLUE CROSS
7120595MedicaidWA

Other names 1

  • KVH Internal Medicine Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932115391. Details of each certification follow.

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
OtherNon-profit
Incorporated
Sep 11, 2009 in WA
Enrollment address
700 E Manitoba Ave
Ellensburg, WA 98926-3885
Related CCNs
501333

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

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Tax ID family
Kittitas Co Pub Hos Dis 116 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

201 Alpha Way
Cle Elum, WA 98922
Phone (509) 674-5331

700 E Manitoba Ave
Ellensburg, WA 98926
Phone (509) 925-6100

Interoperability endpoints

  • Direct secure messaging: acollins@kittitasvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: aschock@kittitasvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: djackson@kittitasvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: jfeng@kittitasvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: kvhgeriatricserv@kittitasvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: mnouwens@kittitasvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: soldenkamp@kittitasvalleyhealthcare.cernerdirect.com

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Lisa Gott Individual W-2 Managing EmployeeDirector Revenue Cycle Operations Jan 1, 2023
Kittitas County Public Hospital Dist 1 Organization, Ellensburg, WA Operational/Managerial Control Jul 26, 2007 100%
Jason Adler Individual Corporate OfficerCeo Dec 15, 2024
W-2 Managing EmployeeAd; Dec 15, 2024

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Kittitas Valley HealthcareEllensburg, WA, CCN 501333 Hospital Operational/Managerial Control (100%) Jan 1, 1966
Kittitas Valley HealthcareEllensburg, WA, CCN 50Z333 Hospital Operational/Managerial Control (100%) Jan 1, 2004
Kittitas Valley Healthcare Home HealthEllensburg, WA, CCN 507097 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1964
Jan 1, 1964
Kittitas Valley Comm Hospital HospiceEllensburg, WA, CCN 501529 Hospice 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 25, 2008
Oct 3, 2011
Kittitas Valley Healthcare Family Medicine Cle ElumCle Elum, WA, CCN 508541 Rural health clinic Operational/Managerial Control (100%) Jul 1, 2005
Medical Arts Center ClinicEllensburg, WA, CCN 508553 Rural health clinic Operational/Managerial Control (100%) Nov 1, 1966

Owned or controlled facilities with NPI records 6

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 104

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 104

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1932115391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 799",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989261921",
            "telephone_number": "509-933-8771",
            "fax_number": "509-962-7604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S CHESTNUT ST",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263875",
            "telephone_number": "509-925-8445",
            "fax_number": "509-925-8464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 S Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Ellensburg",
            "state": "WA",
            "postal_code": "989263875",
            "country_code": "US",
            "telephone_number": "509-962-6100",
            "fax_number": "509-925-7604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KITTITAS COUNTY PUBLIC HOSPITAL DIST 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "GOTT",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "DIRECTOR REVENUE CYCLE OPERATIONS",
        "authorized_official_telephone_number": "509-962-7424"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WA",
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "H 140",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUST",
            "identifier": "0202873",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "152",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7120595",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KVH Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KVH Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellensburg, WA

Sources for this page

Verify at the official NPI Registry.