ST MARY MEDICAL CENTER (NPI# 1215023015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215023015 |
| Entity Type | Organization |
| Organization Name | ST MARY MEDICAL CENTER |
| Other Organization Name | TCU SKILLED NURSING |
| Practice Address |
401 W Poplar Walla Walla WA 99362 |
| Mailing Address |
Po Box 1477 Walla Walla WA 99362 |
| Practice Telephone | 5095225870 |
| Practice Fax Number | 5095225751 |
| Mailing Telephone | 5095225900 |
| Mailing Fax Number | 5095225578 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MICHAEL PARENTEAU (CFO) |
| Authorized Official Telephone | 5095253320 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | H050 | WA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 4212015 | 05 | |
| OR | MEDICAID | 800026 | 01 |
| WA | L & I | 204884 | 01 |
| Other Name | Type Code |
|---|---|
| TCU Skilled Nursing | 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 |
| 1124114921 | St Mary Medical Center | Home Health | 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 | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548627011 | Washington State Walla Walla Veterans Home | Skilled Nursing Facility | 92 Wainwright Drive, Walla Walla, WA 99362 | 2016-01-28 |
| 1639169097 | Washington Odd Fellows Home | Skilled Nursing Facility | 534 Boyer Avenue, Walla Walla, WA 99362 | 2005-10-26 |
| 1558360024 | Manor Park Healthcare LLC | Skilled Nursing Facility | 1710 Plaza Way, Walla Walla, WA 99362-4362 | 2005-07-18 |
| 1447401260 | Providence Health & Services - Washington | Skilled Nursing Facility | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2008-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821639717 | Atsugi LLC | Skilled Nursing Facility | 23815 Se 28th St, Sammamish, WA 98075 | 2019-10-02 |
| 1457840795 | Mission Healthcare At Renton, LLC | Skilled Nursing Facility | 17420 106th Pl Se, Renton, WA 98055-5438 | 2018-05-02 |
| 1104330349 | North Auburn Health, LLC | Skilled Nursing Facility | 2830 I Street Ne, Auburn, WA 98002 | 2017-11-27 |
| 1831603075 | Fir Lane Health-shelton,llc | Skilled Nursing Facility | 2430 North 13th St, Shelton, WA 98584 | 2017-11-27 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1215455365 | Thirty Three Oaks, LLC | Skilled Nursing Facility | 400 E. 33rd St., Vancouver, WA 98663 | 2017-09-08 |
| 1730607953 | Aurora Oaks, LLC | Skilled Nursing Facility | 16357 Aurora Avenue North, Shoreline, WA 98133 | 2017-09-08 |
| 1265950422 | University Place Rehabilitation Center, LLC | Skilled Nursing Facility | 5520 Bridgeport Way W., University Place, WA 98467 | 2017-09-07 |
| 1235662081 | Alexandra Vick | Skilled Nursing Facility | 18621 29th Ave E, Tacoma, WA 98445-4323 | 2017-04-08 |
| 1255883831 | Heron's Key | Skilled Nursing Facility | 4340 Borgen Blvd, Gig Harbor, WA 98332-7000 | 2016-10-28 |
| 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.