NPIMap

Organization Active NPI

Swofford & Halma Clinic, Inc. P.S.

  • Family Medicine Physician
  • Sunnyside, WA
National Provider Identifier
1992758486
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
600135300 Issued in WA
Legal business name
SWOFFORD & HALMA CLINIC, INC. P.S.
Practice address
2303 Reith Way
Sunnyside, WA 98944
Phone
(509) 837-3933
Fax
(509) 837-3885
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Authorized official

Name
Harlan D Halma, MDNPI 1487609814
Title
Co-Owner
Phone
(509) 837-3933

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 600135300 WA Primary

Addresses

Primary practice location

2303 Reith Way
Sunnyside, WA 98944

Mailing address

PO Box 119
Sunnyside, WA 98944
Phone (509) 837-3933

Other identifiers 4

IdentifierTypeStateIssuer
8156861MedicaidWA
8325193MedicaidWA
9632795MedicaidWA
8283707MedicaidWA

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040401000758 WA Part B Supplier - Clinic/Group Practice 3375535024 Receives reassigned benefits from 17 practitioners
Practice locations: Sunnyside, WA
O20051012000213 WA Part A Provider - Rural Health Clinic 3375535024 Practice locations: Sunnyside, WA

Rural health clinic certification: CCN 503908

Legal name
SWOFFORD & HALMA CLINIC, INC. P.S.
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 13, 2006
Last certification
Aug 22, 2023
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Feb 28, 2003 in WA
Enrollment address
2303 Reith Way
Sunnyside, WA 98944

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0867817Swofford and Halma Clinic Inc PS2303 Reith Way, Sunnyside, WA 98944Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory

Locations

2303 Reith Way
Sunnyside, WA 98944
Phone (509) 837-3933

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IFAADD

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Blake Bond Individual 5% Or Greater Direct Ownership Interest Jan 1, 2021 50%
Harlan D Halma Individual 5% Or Greater Direct Ownership Interest Feb 28, 2003
Corporate Director Oct 12, 2005
Estela Cardenas Individual W-2 Managing EmployeeOffice Manager Sep 15, 2018 33%

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665100800000",
    "number": "1992758486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 119",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "98944",
            "telephone_number": "509-837-3933",
            "fax_number": "509-837-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 REITH WAY",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "98944",
            "telephone_number": "509-837-3933",
            "fax_number": "509-837-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWOFFORD & HALMA CLINIC, INC. P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A",
        "authorized_official_last_name": "HALMA",
        "authorized_official_first_name": "HARLAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "509-837-3933",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "600135300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8156861",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8325193",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9632795",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8283707",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, WA

Sources for this page

Verify at the official NPI Registry.