NPIMap

Organization Active NPI

Whidbey Island Public Hospital District

  • Critical Access Hospital
  • Clinton, WA
National Provider Identifier
1992823595
Registry record updated Jun 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Practice address
11245 State Route 525
Clinton, WA 98236-8638
Phone
(360) 341-5252
Fax
(360) 341-8727
NPI assigned
Mar 26, 2007
Organization subpart
Yes
Parent organization
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICTAs reported in NPPES

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

Other NPIs on the same Medicare enrollment 5

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

Affiliated clinicians 336

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

View all 336

Care Compare: Hospital

Medicare Care Compare
Listed as
Whidbeyhealth Medical CenterCCN 501339
Overall star rating
2 of 5
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071105000513 WA Part A Provider - Critical Access Hospital 1658280680 Receives reassigned benefits from 55 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clinton, WA; Coupeville, WA; Oak Harbor, WA

Hospital certification: CCN 501339

Legal name
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Doing business as
WHIDBEYHEALTH MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 31, 2005
Last certification
Jul 22, 2020
Beds
51
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Enrollment address
101 N Main St
Coupeville, WA 98239-3413
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

All disclosed owners & managing parties 10

Medicare enrollment files

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 1, 1966 100%
Curtis Andrew Shumate Individual Corporate DirectorExecutive Director of Nursing Feb 1, 2022
W-2 Managing Employee Feb 22, 2010
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 Officer Jan 1, 2022
Corporate Director Jan 1, 2022
Mark Ethan Borden Individual Corporate OfficerCommissioner Jan 1, 2026
Corporate DirectorCommissioner Jan 1, 2026
Marion Louise Jouas Individual Corporate DirectorCommissioner Dec 14, 2023
Jamie Canby Individual Corporate OfficerCommissioner Jan 1, 2026
Corporate DirectorCommissioner Jan 1, 2026
Paul Rogers Individual Corporate OfficerInterim Cfo Sep 16, 2022
Corporate DirectorInterim Cfo Sep 16, 2022
Nathan Staggs Individual Corporate OfficerCeo Mar 22, 2023
Corporate DirectorCeo Mar 22, 2023
W-2 Managing EmployeeCeo Mar 22, 2023

National Provider Directory

National Provider Directory
Tax ID family
North Whidbey Comm Clin38 organizations share this tax ID, including this one
Part of
North Whidbey Comm Clin

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPPES NPI Registry

Updated by the provider on Jun 10, 2016

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

Authorized official

Name
Ronald Telles
Title
Cfo
Phone
(360) 678-7656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

11245 State Route 525
Clinton, WA 98236-8638

Mailing address

PO Box 3603
Seattle, WA 98124-3603
Phone (360) 341-5252

Other identifiers 1

IdentifierTypeStateIssuer
7099013MedicaidWA

Other names 1

  • WhidbeyHealth Medical Center Primary Care - Outpatient Care Other name

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465516800000",
    "number": "1992823595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3603",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243603",
            "telephone_number": "360-341-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11245 STATE ROUTE 525",
            "city": "CLINTON",
            "state": "WA",
            "postal_code": "982368638",
            "telephone_number": "360-341-5252",
            "fax_number": "360-341-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "enumeration_date": "2007-03-26",
        "last_updated": "2016-06-10",
        "status": "A",
        "authorized_official_last_name": "TELLES",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "360-678-7656"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7099013",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WhidbeyHealth Medical Center Primary Care - Outpatient Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clinton, WA

Sources for this page

Verify at the official NPI Registry.