NPIMap

Organization Active NPI

Whidbey Island Public Hospital District

  • Community Based Hospice Care Agency
  • Coupeville, WA
National Provider Identifier
1972776581
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
IS-323 Issued in WA
Legal business name
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Practice address
101 NE Birch St
Coupeville, WA 98239-3133
Phone
(360) 914-5635
Fax
(360) 678-1013
NPI assigned
Apr 4, 2008
Last updated
Feb 10, 2025By 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 Feb 10, 2025

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

Authorized official

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

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X IS-323 WA Primary
Critical Access Hospital 282NC0060X H-156 WA

Addresses

Primary practice location

101 NE Birch St
Coupeville, WA 98239-3133

Mailing address

101 NE Birch St
Coupeville, WA 98239-3133
Phone (360) 914-5635

Other practice location 1

101 N Main St
Coupeville, WA 98239-3413
Phone (360) 678-5151

Other names 1

  • WhidbeyHealth Hospice Care Other name

Medicare participation

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

Enrollment records 2

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
O20130308000509 WA Part A Provider - Hospice 1658280680 Practice locations: Coupeville, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972776581. Details of each certification follow.

Hospice certification: CCN 501542

Legal name
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Doing business as
WHIDBEYHEALTH HOSPICE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 12, 2014
Last certification
May 6, 2021
Ownership / control type
Government - County
Organization structure
OtherNon-profit
Enrollment address
101 NE Birch St
Coupeville, WA 98239-3133

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 16

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

View all 16

Care Compare: Hospice

Medicare Care Compare
Listed as
Whidbeyhealth Hospice and Palliative CareCCN 501542 · All quality measures
Ownership
Government
Certified
Jun 12, 2014
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Part of
Whidbey Island Pub Hospital

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Whidbey Island Public Hospital District Organization, Coupeville, WA 5% Or Greater Direct Ownership Interest Jan 30, 2013 100%
Curtis Andrew Shumate Individual Corporate DirectorExecutive Director of Nursing Feb 1, 2022
W-2 Managing Employee Feb 22, 2010
Shana Fogarty Individual Corporate DirectorDirector of Hospice Feb 7, 2022
W-2 Managing EmployeeDirector of Hospice Feb 7, 2022
Kirk P Gasper Individual Corporate OfficerCommissioner Dec 2, 2025
Corporate DirectorCommissioner Dec 2, 2025
Garth a Miller Individual Corporate OfficerChief Operations Officer Sep 23, 2021
Corporate DirectorChief Operations Officer Sep 23, 2021
W-2 Managing Employee Aug 1, 2018
James Dean Golder Individual Corporate OfficerCommissioner Jan 1, 2022
Mark Ethan Borden Individual Corporate OfficerCommissioner Jan 1, 2026
Corporate DirectorCommissioner Jan 1, 2026
Marion Louise Jouas Individual Corporate OfficerCommissioner Dec 14, 2023
Jamie Canby Individual Corporate OfficerCommissioner Jan 1, 2026
Corporate DirectorCommissioner Jan 1, 2026
Paul Rogers Individual Corporate OfficerCfo Sep 16, 2022
Corporate DirectorCfo Sep 16, 2022
W-2 Managing EmployeeCfo Sep 16, 2022
Nathan Staggs Individual Corporate OfficerCeo Mar 22, 2023
Corporate DirectorCeo Mar 22, 2023
W-2 Managing EmployeeCeo Mar 22, 2023

Owners & managing parties with NPI records 13

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 13

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Whidbeyhealth Medical CenterCoupeville, WA, CCN 501339 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Whidbeyhealth Medical CenterCoupeville, WA, CCN 50Z339 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 1966
Whidbeyhealth Primary Care - Goldie St.Oak Harbor, WA, CCN 503996 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 1, 1962
Jan 1, 1962
Whidbeyhealth Primary Care - ClintonClinton, WA, CCN 508506 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 1, 1962
Jan 1, 1962
Whidbeyhealth Primary Care - FreelandFreeland, WA, CCN 508585 Rural health clinic Other (100%) Apr 1, 1969
Whidbeyhealth Primary Care - CabotOak Harbor, WA, CCN 508584 Rural health clinic Other Apr 1, 2011
Whidbeyhealth Primary Care - CoupevilleCoupeville, WA, CCN 508583 Rural health clinic Other (100%) Apr 1, 1969

Owned or controlled facilities with NPI records 12

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

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 8

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.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1972776581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NE BIRCH ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982393133",
            "telephone_number": "360-914-5635",
            "fax_number": "360-678-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NE BIRCH ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982393133",
            "telephone_number": "360-914-5635",
            "fax_number": "360-678-1013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 N Main St",
            "address_purpose": "LOCATION",
            "city": "Coupeville",
            "state": "WA",
            "postal_code": "982393413",
            "country_code": "US",
            "telephone_number": "360-678-5151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "enumeration_date": "2008-04-04",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GARTH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "360-678-7656"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WA",
            "license": "IS-323",
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WA",
            "license": "H-156",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WhidbeyHealth Hospice Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "WhidbeyHealth Hospice Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Coupeville, WA

Sources for this page

Verify at the official NPI Registry.