NPIMap

Organization Active NPI

Whidbey Island Public Hospital District

  • Family Medicine Physician
  • Coupeville, WA
National Provider Identifier
1972075877
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Practice address
77 N Main St
Coupeville, WA 98239-9556
Phone
(360) 682-2814
Fax
(360) 678-7614
NPI assigned
Dec 18, 2018
Last updated
Jan 11, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Authorized official

Name
Garth MillerNPI 1801082102
Title
Coo
Phone
(360) 678-7656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

77 N Main St
Coupeville, WA 98239-9556

Mailing address

PO Box 24789
Seattle, WA 98124-0789
Phone (360) 678-7656

Other names 1

  • WhidbeyHealth Primary Care Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040210000761 WA Part B Supplier - Clinic/Group Practice 1658280680 Receives reassigned benefits from 136 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory
Part of
Whidbey Island Pub Hospital

Practitioners & affiliated clinicians

Practitioners 12

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": "1545091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1972075877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24789",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981240789",
            "telephone_number": "360-678-7656",
            "fax_number": "360-678-7668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 N MAIN ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982399556",
            "telephone_number": "360-682-2814",
            "fax_number": "360-678-7614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "enumeration_date": "2018-12-18",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GARTH",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "360-678-7656"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WhidbeyHealth Primary Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "WhidbeyHealth Primary Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Coupeville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.