NPIMap

Organization Active NPI

Kittitas County Public Hospital Dist 1

Doing business as KVH Hospitalist

  • Specialist
  • Ellensburg, WA
National Provider Identifier
1932354909
Registry record updated Nov 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
H 140 Issued in WA
Legal business name
KITTITAS COUNTY PUBLIC HOSPITAL DIST 1
Doing business as
KVH Hospitalist
Practice address
700 E Manitoba Ave Ste 101
Ellensburg, WA 98926-3885
Phone
(509) 962-9841
Fax
(509) 962-7351
NPI assigned
Nov 18, 2008
Last updated
Nov 22, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
KITTITAS COUNTY PUBLIC HOSPITAL DIST 1As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 22, 2017

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

Authorized official

Name
Mrs. Jean Roberson
Title
Director Cbo
Phone
(509) 933-8771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X H 140 WA Primary

Addresses

Primary practice location

700 E Manitoba Ave Ste 101
Ellensburg, WA 98926-3885

Mailing address

P.O. Box 799
Ellensburg, WA 98926
Phone (509) 962-9841

Other names 1

  • KVH Hospitalist Doing business as

Medicare participation

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

Enrollment records 1

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

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
Part of
Kittitas Co Pub Hos Dis 1

Locations

603 S Chestnut St
Ellensburg, WA 98926
Phone (509) 933-8693

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511308800000",
    "number": "1932354909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 799",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "98926",
            "telephone_number": "509-962-9841",
            "fax_number": "509-925-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MANITOBA AVE STE 101",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263885",
            "telephone_number": "509-962-9841",
            "fax_number": "509-962-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITTITAS COUNTY PUBLIC HOSPITAL DIST 1",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KITTITAS COUNTY PUBLIC HOSPITAL DIST 1",
        "enumeration_date": "2008-11-18",
        "last_updated": "2017-11-22",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "DIRECTOR CBO",
        "authorized_official_telephone_number": "509-933-8771",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "H 140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KVH Hospitalist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellensburg, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.