OUR LADY OF LOURDES HEALTH CENTER (NPI# 1184708471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184708471 |
| Entity Type | Organization |
| Organization Name | OUR LADY OF LOURDES HEALTH CENTER |
| Other Organization Name | LOURDES RIVERVIEW MEDICAL GROUP |
| Practice Address |
4403 W Court St Suite B Pasco WA 99301-2879 |
| Practice Telephone | 5095455358 |
| Mailing Telephone | 5095456620 |
| Mailing Fax Number | 5095456842 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2009-04-17 |
| Authorized Official Name | MR. JOHN SERLE (PRESIDENT & CEO) |
| Authorized Official Telephone | 5095432483 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
113003371 | WA | Allopathic & Osteopathic Physicians |
| N | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
113003371 | WA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 113003371 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7093933 | 05 |
| Other Name | Type Code |
|---|---|
| LOURDES RIVERVIEW MEDICAL GROUP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659505840 | Our Lady of Lourdes Health Center | Obstetrics & Gynecology | 7425 Wrigley Drive, Pasco, WA 99301 | 2009-05-04 |
| 1649785569 | Our Lady of Lourdes Health Center | Urology | 507 N 5th Ave, Pasco, WA 99301-5201 | 2017-12-14 |
| 1235678772 | Our Lady of Lourdes Health Center | Psychiatric Residential Treatment Facility | 1175 Carondelet Dr, Richland, WA 99354-3300 | 2017-02-16 |
| 1700245511 | Our Lady of Lourdes Health Center | Pharmacy | 1175 Carondelet Dr, Attn: Pharmacy, Richland, WA 99354-3300 | 2016-02-22 |
| 1821386822 | Our Lady of Lourdes Health Center | Acupuncturist | 520 N 4th Ave, Pasco, WA 99301-5257 | 2011-07-12 |
| 1326335712 | Our Lady of Lourdes Health Center | Pediatrics | 815 S Auburn St, Kennewick, WA 99336-5661 | 2011-07-06 |
| 1093006447 | Our Lady of Lourdes Health Center | Family Medicine | 1200 N 14th Ave, Pasco, WA 99301-4182 | 2011-04-20 |
| 1518267129 | Our Lady of Lourdes Health Center | Surgery | 1200 N 14th Ave, Suite 400, Pasco, WA 99301-4182 | 2010-10-28 |
| 1366682973 | Our Lady of Lourdes Health Center | Hospitalist | 520 N 4th Ave, Pasco, WA 99301-5257 | 2009-02-23 |
| 1104093368 | Our Lady of Lourdes Health Center | Clinic/Center | 5304 N Road 68, Pasco, WA 99301-9189 | 2008-05-15 |
| Street Address |
4403 W COURT ST SUITE B |
| City | PASCO |
| State | WA |
| Zip Code | 99301-2879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598735110 | Daniel C Perdue | Optometrist | 4403 W Court St, Suite J, Pasco, WA 99301-2879 | 2006-01-25 |
| 1700226180 | Nicholas Gubler | Optometrist | 4403 W Court St, Ste J, Pasco, WA 99301-2879 | 2013-06-28 |
| 1548584337 | Dennis L Bradshaw | Dentist | 4403 W Court St, Suite A, Pasco, WA 99301-2879 | 2010-03-23 |
| 1508991951 | Dernnis Lyle Bradshaw | Dentist | 4403 W Court St, Suite A, Pasco, WA 99301-2879 | 2007-02-23 |
| 1245365618 | Robert Waldo Bradshaw | Dentist | 4403 W Court St, Suite A, Pasco, WA 99301-2879 | 2007-02-23 |
| 1376580399 | Carrie V West | Physician Assistant | 4403 W Court St, Suite B, Pasco, WA 99301-2879 | 2006-05-31 |
| 1457321069 | Mark A Michael | Optometrist | 4403 W Court St, Suite J, Pasco, WA 99301-2879 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710504550 | Kayshuv Enterprises | Pharmacy | 7505 Sandifur Pkwy, Suite 102, Pasco, WA 99301 | 2020-06-27 |
| 1558883157 | Cecilia Carmen Asenjo | Registered Nurse | 715 W Court Street, Pasco, WA 99301 | 2017-07-14 |
| 1528451085 | Felix Ramos | Dentist | 7425 Wrigley Dr Ste 201, Pasco, WA 99301 | 2015-03-09 |
| 1861896631 | Tri-cities Community Health | General Practice | 1801 E Sheppard St, Pasco, WA 99301 | 2014-10-22 |
| 1649617861 | Thompson.ferguson,steinhart. James.pllc | Dentist | 6525 Burden Blvd, Pasco, WA 99301 | 2013-05-29 |
| 1598008880 | Thompson. Ferguson. Steinhart. James, Pllc | Dentist | 6525 Burden Boulevard, Pasco, WA 99301 | 2013-04-04 |
| 1639421720 | Comprehensive Healthcare | Community/Behavioral Health | 2715 Saint Andrews Loop, Suite C, Pasco, WA 99301 | 2012-10-12 |
| 1497065395 | Danny M Trapp Jr. | Counselor | 516 W. Margaret, Pasco, WA 99301 | 2010-10-14 |
| 1740510486 | Columbia Basin College | Dental Hygienist | 2600 N 20th Ave, Ms T-1, Pasco, WA 99301 | 2009-12-31 |
| 1417286386 | Wanda Marie Good | Surgery | 1200 N 14th Ave Ste 255, Pasco, WA 99301 | 2009-12-23 |
| Find all providers in zip 99301 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790015766 | Peresi Kamazoob Kahirimbanyi | Family Medicine | 7425 Wrigley Dr Ste 100, Pasco, WA 99301-5292 | 2010-01-13 |
| 1023252814 | Juan Carlos Hernandez Umana | Family Medicine | 3905 Sandifur Parkway, Pasco, WA 99301 | 2009-04-24 |
| 1093925794 | Travis Alexander Najera | Family Medicine | 1620 N Road 44, Pasco, WA 99301-2667 | 2007-05-23 |
| 1770799579 | Faustino Riojas Jr. | Family Medicine | 707 W Margaret, Pasco, WA 99301 | 2007-05-16 |
| 1477689834 | Victor O Brooks | Family Medicine | 1525 W Court St, Pasco, WA 99301 | 2007-02-27 |
| 1366533481 | Jonathan P Crosier | Family Medicine | 515 West Court, Pasco, WA 99301 | 2006-09-27 |
| 1912953860 | David William Jones | Family Medicine | 9605 Sandifur Parkway, Kadlec Clinic-primary Care, Pasco, WA 99301 | 2006-05-25 |
| 1366407181 | Mark Spencer | Family Medicine | 1608 Road 44, Pasco, WA 99301-2667 | 2006-04-18 |
| 1497733877 | Jerry L Hiner | Family Medicine | 515 West Court St, Pasco, WA 99301 | 2006-01-05 |
| 1114905825 | Kathryn L Soudah | Family Medicine | 5025 Rd 68 Ste G #186, Pasco, WA 99301 | 2006-01-03 |
| Find all providers in PASCO | ||||
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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.