NPIMap

Organization Active NPI

Lewis County Hospital District No. 1

Doing business as Arbor Health Morton Clinic

  • Rural Health Clinic/Center
  • Morton, WA
National Provider Identifier
1952415432
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
602086651 Issued in WA
Legal business name
LEWIS COUNTY HOSPITAL DISTRICT NO. 1
Doing business as
Arbor Health Morton Clinic
Practice address
521 Adams Ave Ste B
Morton, WA 98356-9323
Phone
(360) 496-5145
NPI assigned
Aug 19, 2006
Last updated
Feb 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

Name
Richard Darrell Boggess
Title
Cfo
Phone
(360) 496-3647

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 602086651 WA
Rural Health Clinic/Center 261QR1300X 602086651 WA Primary

Addresses

Primary practice location

521 Adams Ave Ste B
Morton, WA 98356-9323

Mailing address

PO Box 1138
Morton, WA 98356-0019
Phone (360) 496-5145

Other identifiers 6

IdentifierTypeStateIssuer
8432775MedicaidWA
8273443MedicaidWA
7105687MedicaidWA
50D063567OtherWACLIA
8273450MedicaidWA
8273435MedicaidWA

Other names 1

  • Arbor Health Morton Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040121000814 WA Part B Supplier - Clinic/Group Practice 6002727385 Receives reassigned benefits from 60 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Morton, WA; Mossyrock, WA; Packwood, WA; Randle, WA
O20200428002444 WA Part A Provider - Rural Health Clinic 6002727385 Practice locations: Morton, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952415432. Details of each certification follow.

Rural health clinic certification: CCN 508590

Legal name
LEWIS COUNTY HOSPITAL DISTRICT NO 1
Doing business as
ARBOR HEALTH MORTON CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 13, 2020
Last certification
Jan 14, 2015
Ownership / control type
1C
Organization structure
OtherProprietary
Incorporated
Dec 2, 1976 in WA
Enrollment address
521 Adams Ave
Ste B
Morton, WA 98356-9323
Related CCNs
501319

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 5

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Janice Cramer Individual Corporate Director Apr 11, 2025
Operational/Managerial Control Aug 1, 2025
Tom Herrin Individual Corporate DirectorCommissioner Jan 1, 2020
Eric Neal Individual Corporate OfficerCeo Aug 25, 2025
W-2 Managing EmployeeAd; Aug 25, 2025
Wes McMahan Individual Corporate DirectorCommissioner Jan 1, 2020

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Arbor Health Morton HospitalMorton, WA, CCN 501319 Hospital Operational/Managerial Control Dec 2, 1976
Arbor Health Morton HospitalMorton, WA, CCN 50Z319 Hospital Operational/Managerial Control Dec 2, 1976
Arbor Health Randle ClinicRandle, WA, CCN 508511 Rural health clinic Other Dec 2, 1976
Arbor Health Packwood ClinicPackwood, WA, CCN 508597 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2023
Apr 1, 2023

Owned or controlled facilities with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1952415432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1138",
            "city": "MORTON",
            "state": "WA",
            "postal_code": "983560019",
            "telephone_number": "360-496-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 ADAMS AVE STE B",
            "city": "MORTON",
            "state": "WA",
            "postal_code": "983569323",
            "telephone_number": "360-496-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS COUNTY HOSPITAL DISTRICT NO. 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "BOGGESS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "DARRELL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "360-496-3647"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "602086651",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WA",
            "license": "602086651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8432775",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8273443",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7105687",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "50D063567",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8273450",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8273435",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arbor Health Morton Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morton, WA

Sources for this page

Verify at the official NPI Registry.