ST MARY MEDICAL CENTER (NPI# 1124114921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124114921 |
| Entity Type | Organization |
| Organization Name | ST MARY MEDICAL CENTER |
| Other Organization Name | HOME HEALTH |
| Practice Address |
401 W Poplar Walla Walla WA 99362 |
| Mailing Address |
Po Box 1477 Walla Walla WA 99362 |
| Practice Telephone | 5095225710 |
| Practice Fax Number | 5095225872 |
| Mailing Telephone | 5095225900 |
| Mailing Fax Number | 5095225578 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2008-10-02 |
| Authorized Official Name | SUSAN COLUMBER (DIR OF REVENUE CYCLE MANAGEMENT) |
| Authorized Official Telephone | 5095225906 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | IS446 | WA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 711956 | 05 | |
| WA | L & I | 74073 | 01 |
| WA | 9109703 | 05 |
| Other Name | Type Code |
|---|---|
| Home Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801215587 | St Mary Medical Center | General Acute Care Hospital | 1201 Newtown-langhorne Road, Langhorne, PA 19047 | 2014-04-10 |
| 1922246545 | St Mary Medical Center | General Acute Care Hospital | 500 Hilbrich Dr, Schererville, IN 46375-4300 | 2009-02-04 |
| 1083622286 | St Mary Medical Center | Pediatrics | 2546 Knights Rd, Bensalem, PA 19020 | 2006-08-03 |
| 1225072176 | St Mary Medical Center | Home Health | 3405 N Seminary St, Galesburg, IL 61401-1251 | 2006-06-15 |
| 1780686931 | St Mary Medical Center | Rehabilitation Unit | 1201 Langhorne-newtown Rd, Langhorne, PA 19047-1295 | 2005-06-01 |
| 1710470323 | St Mary Medical Center | Internal Medicine | 2546b Knights Rd, Bensalem, PA 19020 | 2018-06-08 |
| 1255743183 | St Mary Medical Center | General Acute Care Hospital | 1201 Newtown-langhorne Road, Langhorne, PA 19047 | 2014-05-27 |
| 1922439785 | St Mary Medical Center | Anesthesiology | 3333 N Seminary St, Galesburg, IL 61401-1251 | 2013-12-04 |
| 1437425741 | St Mary Medical Center | General Acute Care Hospital | 1201 Langhorne Newtown Rd, Langhorne, PA 19047-1201 | 2012-03-30 |
| 1457629974 | St Mary Medical Center | General Acute Care Hospital | 1050 Linden Ave, Long Beach, CA 90813-3321 | 2011-12-12 |
| Street Address |
401 W POPLAR |
| City | WALLA WALLA |
| State | WA |
| Zip Code | 99362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225052996 | Shirley Robin Vonhaven | Emergency Medicine | 401 W Poplar, Walla Walla, WA 99362 | 2006-07-27 |
| 1568671758 | St Mary Medical Center | Clinic/Center | 401 W Poplar, Walla Walla, WA 99362 | 2007-05-22 |
| 1679785109 | Seymour Maynard Bronstein,p.s. | Internal Medicine | 401 W Poplar, Walla Walla, WA 99362 | 2007-05-04 |
| 1073698437 | St Mary Medical Center | Emergency Medicine | 401 W Poplar, Walla Walla, WA 99362 | 2006-10-26 |
| 1093801896 | St Mary Medical Center | Rehabilitation Unit | 401 W Poplar, Walla Walla, WA 99362 | 2006-10-05 |
| 1215023015 | St Mary Medical Center | Skilled Nursing Facility | 401 W Poplar, Walla Walla, WA 99362 | 2006-10-05 |
| 1740393008 | St Mary Medical Center | General Acute Care Hospital | 401 W Poplar, Walla Walla, WA 99362 | 2006-08-17 |
| 1952414211 | Stephen Rubin | Psychologist | 401 W Poplar, Walla Walla, WA 99362 | 2006-08-17 |
| 1124032511 | Timothy A Davidson | Internal Medicine | 401 W Poplar, Walla Walla, WA 99362 | 2006-07-28 |
| 1942214333 | Richard D Simon Jr. | Internal Medicine | 401 W Poplar, Walla Walla, WA 99362 | 2006-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164065959 | Kevin Gia-minh Phan | Optometrist | Walla Walla Vamc Bldg 86, Walla Walla, WA 99362 | 2019-10-24 |
| 1659836401 | Arlene Lavonne Whitney | Social Worker | 1361 Dalles Military Road, Walla Walla, WA 99362 | 2019-02-06 |
| 1053880674 | Julie Ann Cooke | Speech-Language Pathologist | Providence St. Mary Medical Center, 401 W. Poplar St., Walla Walla, WA 99362 | 2018-11-14 |
| 1558887133 | Chantey Walker | Massage Therapist | 1840 Pleasant St, Walla Walla, WA 99362 | 2017-08-16 |
| 1447798723 | Carrie S Diede | Speech-Language Pathologist | 410 West Poplar Street, Rehabilitation Services, Walla Walla, WA 99362 | 2017-02-07 |
| 1235584103 | Anchor Point Counseling Pllc | Clinic/Center | 2330 Eastgate St. Ste. 140, Walla Walla, WA 99362 | 2016-04-28 |
| 1548627011 | Washington State Walla Walla Veterans Home | Skilled Nursing Facility | 92 Wainwright Drive, Walla Walla, WA 99362 | 2016-01-28 |
| 1073926200 | Sherry Goff | Registered Nurse | 11120 W Rose St, Family Medical Center, Walla Walla, WA 99362 | 2014-06-05 |
| 1538597935 | Michael Wade Gillespie | Orthopaedic Surgery | 101 Brookside Drive, Walla Walla, WA 99362 | 2013-10-22 |
| 1023357985 | Sandra Kay Bushnell | Speech-Language Pathologist | 1105 Isaacs Ave, Walla Walla, WA 99362 | 2013-02-12 |
| Find all providers in zip 99362 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134593593 | Santana LLC | Home Health | 5 W Alder St Ste 202, Walla Walla, WA 99362-2863 | 2015-11-23 |
| 1558512368 | Providence Health & Services - Washington | Home Health | 209 W Poplar St, Walla Walla, WA 99362 | 2008-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433481 | Malaika Home Care LLC | Home Health | 10518 N Russett Dr, Spokane, WA 99208-6729 | 2020-09-30 |
| 1619582632 | Flowing Water Venture Inc. | Home Health | 23453 16th Ave S Apt A304, Des Moines, WA 98198-8042 | 2020-09-15 |
| 1477163236 | Pnw Kupuna Care, LLC | Home Health | 203 S 4th Ave, Sequim, WA 98382-3719 | 2020-08-06 |
| 1538778295 | Eden Home Health of Clark County, LLC | Home Health | 4601 Ne 77th Ave Ste 300, Vancouver, WA 98662-6736 | 2020-07-29 |
| 1033736160 | Home Health Seattle LLC | Home Health | 19803 1st Ave S Ste 200, Normandy Park, WA 98148-2410 | 2020-07-06 |
| 1265053920 | Premier Care Services | Home Health | 13555 Ne Bel Red Rd Ste 113, Bellevue, WA 98005-2324 | 2020-05-04 |
| 1861011330 | Samuel Kihiu Njenga | Home Health | 3607 27th St Se, Puyallup, WA 98374-1716 | 2020-04-14 |
| 1972136745 | Tender Angels Home Care | Home Health | 11900 Ne 1st St Bldg G, Bellevue, WA 98005-3046 | 2020-02-19 |
| 1154953628 | Meliorahealthcare Pllc | Home Health | 17539 10th Ave Nw, Shoreline, WA 98177-3804 | 2020-02-12 |
| 1235786781 | Ahhpc, Inc. | Home Health | 907 W Boone Ave Ste B, Spokane, WA 99201-2503 | 2019-08-20 |
| Find all providers with the same taxonomy | ||||
| City | WALLA WALLA |
| Zip Code | 99362 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.