NPIMap

Organization Active NPI

Tri-Cities Chaplaincy

Doing business as Tri-Cities Chaplaincy Supportive Care

  • Nurse Practitioner
  • Richland, WA
National Provider Identifier
1992070346
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
TRI-CITIES CHAPLAINCY
Doing business as
Tri-Cities Chaplaincy Supportive Care
Practice address
1480 Fowler St
Richland, WA 99352-4717
Phone
(509) 783-7416
Fax
(509) 735-7850
NPI assigned
Mar 19, 2012
Last updated
Oct 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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

Authorized official

Name
Mr. Paul Well
Title
Executive Director
Phone
(509) 783-7416

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X WA Primary

Addresses

Primary practice location

1480 Fowler St
Richland, WA 99352-4717

Mailing address

1480 Fowler St
Richland, WA 99352-4717
Phone (509) 783-7416

Other names 1

  • TRI-CITIES CHAPLAINCY SUPPORTIVE CARE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040428000476 WA Part B Supplier - Clinic/Group Practice 0143217562 Receives reassigned benefits from 9 practitioners
Practice locations: Richland, WA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

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": "1332115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1992070346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 FOWLER ST",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524717",
            "telephone_number": "509-783-7416",
            "fax_number": "509-735-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 FOWLER ST",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524717",
            "telephone_number": "509-783-7416",
            "fax_number": "509-735-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITIES CHAPLAINCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-19",
        "last_updated": "2013-10-09",
        "status": "A",
        "authorized_official_last_name": "WELL",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "509-783-7416",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRI-CITIES CHAPLAINCY SUPPORTIVE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.