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Organization Active NPI

Public Hospital District No 2, Klickitat County Washington

Doing business as Skyline Hospital

  • Critical Access Hospital
  • White Salmon, WA
National Provider Identifier
1952483653
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
H-096 Issued in WA
Legal business name
PUBLIC HOSPITAL DISTRICT NO 2, KLICKITAT COUNTY WASHINGTON
Doing business as
Skyline Hospital
Practice address
211 Skyline Drive
White Salmon, WA 98672
Phone
(509) 493-1101
Fax
(509) 493-4607
NPI assigned
Oct 20, 2006
Last updated
Jul 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Authorized official

Name
Robert Kimmes
Title
Ceo
Phone
(509) 493-1101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X H-096 WA Primary

Addresses

Primary practice location

211 Skyline Drive
White Salmon, WA 98672

Mailing address

PO Box 99
White Salmon, WA 98672
Phone (509) 493-1101

Other identifiers 1

IdentifierTypeStateIssuer
7171200MedicaidWA

Other names 1

  • Skyline Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309000490 WA Part B Supplier - Clinic/Group Practice 4981592144 Receives reassigned benefits from 90 practitioners
Practice locations: Stevenson, WA; White Salmon, WA

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Skyline HospitalWhite Salmon, WA, CCN 501315 Hospital Operational/Managerial Control (100%) Jan 1, 1966
Skyline HospitalWhite Salmon, WA, CCN 50Z315 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1966
Jan 1, 1966
Skyline Medical ClinicWhite Salmon, WA, CCN 508573 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2017

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 92

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 92

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1952483653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "98672",
            "telephone_number": "509-493-1101",
            "fax_number": "509-493-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SKYLINE DRIVE",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "98672",
            "telephone_number": "509-493-1101",
            "fax_number": "509-493-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DISTRICT NO 2, KLICKITAT COUNTY WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "KIMMES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-493-1101"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WA",
            "license": "H-096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7171200",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skyline Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in White Salmon, WA

Sources for this page

Verify at the official NPI Registry.