NPIMap

Organization Active NPI

Lewis County Community Health Services

Doing business as Valley View Health Center

  • Federally Qualified Health Center (FQHC)
  • Toledo, WA
National Provider Identifier
1942569637
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LEWIS COUNTY COMMUNITY HEALTH SERVICES
Doing business as
Valley View Health Center
Practice address
117 Ramsey Way
Toledo, WA 98591
Phone
(360) 864-4400
Fax
(360) 864-4239
NPI assigned
May 15, 2012
Last updated
Mar 31, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Authorized official

Name
Steven Clark
Title
Executive Director
Phone
(360) 330-9595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

117 Ramsey Way
Toledo, WA 98591

Mailing address

2690 NE Kresky Ave
Chehalis, WA 98532-2412
Phone (360) 330-9595

Other identifiers 1

IdentifierTypeStateIssuer
G8801670OtherWAMEDICARE GROUP

Other names 1

  • Valley View Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040426001899 WA Part B Supplier - Clinic/Group Practice 6002803749 Receives reassigned benefits from 82 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winlock, WA; Toledo, WA; Tenino, WA; Raymond, WA; Pe Ell, WA; Onalaska, WA; Olympia, WA; Centralia, WA…
O20060425000394 WA Part A Provider - Federally Qualified Health Center (FQHC) 6002803749 Practice locations: Toledo, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942569637. Details of each certification follow.

Federally qualified health center certification: CCN 501897

Legal name
LEWIS COUNTY COMMUNITY HEALTH SERVICES
Doing business as
VALLEY VIEW HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 8, 2006
Last certification
May 8, 2006
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jul 18, 2003 in WA
Enrollment address
117 Ramsey Way
Toledo, WA 98591

Other NPIs with the same Medicare PAC ID 12

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

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory

Locations

300 Ocean Ave
Raymond, WA 98577
Phone (360) 942-2303

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Patricia Snyder Individual Corporate Director Feb 17, 2017
Jeremy Germann Individual Corporate OfficerTreasurer Jan 1, 2019
Corporate Director Jan 25, 2016
Gricelda Sanchez Individual Corporate Director Feb 17, 2017
David Pavletich Individual Corporate Director Jan 25, 2016
Kiandre Brasher Individual Corporate Director Feb 27, 2017
Bruce Binder Individual Corporate OfficerVice President Jan 1, 2019
Corporate Director Apr 24, 2017
Marrianne Schumacher Individual Corporate OfficerBoard Secretary Jan 1, 2019
Corporate Director Apr 24, 2017
Steven Skinner Individual Corporate Director Dec 18, 2017
Greg S Martin Individual Corporate OfficerBoard President Jan 1, 2019
Corporate Director Nov 3, 2014
Toni R Gwin Individual Corporate DirectorBoard Member Feb 25, 2013
Gaelon B Spradley Individual Corporate OfficerChief Executive Officer May 1, 2019
W-2 Managing EmployeeCeo May 1, 2019
Operational/Managerial ControlCeo May 20, 2019 100%
Lynda Nanney Individual Corporate DirectorBoard Member Nov 21, 2005
Holly K Sliva Individual W-2 Managing EmployeeChief Financial Officer Sep 23, 2013

All facility ownership & control disclosures 9

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

FacilityTypeRoleSince
Valley View Health CenterCentralia, WA, CCN 501925 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Nov 24, 2013
Valley View Health CenterRaymond, WA, CCN 501926 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 26, 2010
Lewis County Community Health ServicesOnalaska, WA, CCN 501896 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 8, 2006
Valley View Health CenterPe Ell, WA, CCN 501939 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 3, 2012
Valley View Health CenterOlympia, WA, CCN 501954 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 12, 2013
Valley View Health CenterCentralia, WA, CCN 501972 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 2, 2014
Valley View Health CenterTenino, WA, CCN 941030 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2017
Valley View Health CenterOlympia, WA, CCN 501019 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2023
Valley View Health CenterChehalis, WA, CCN 501041 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2023

Owned or controlled facilities with NPI records 10

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

Practitioners & affiliated clinicians

Practitioners 9

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": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459382400000",
    "number": "1942569637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322412",
            "telephone_number": "360-330-9595",
            "fax_number": "360-330-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 RAMSEY WAY",
            "city": "TOLEDO",
            "state": "WA",
            "postal_code": "98591",
            "telephone_number": "360-864-4400",
            "fax_number": "360-864-4239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS COUNTY COMMUNITY HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2016-03-31",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-330-9595"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "G8801670",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley View Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Toledo, WA

Sources for this page

Verify at the official NPI Registry.