PROVIDENCE HEALTH SYSTEM WASHINGTON (NPI# 1508058520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508058520 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH SYSTEM WASHINGTON |
| Other Organization Name | PROVIDENCE CENTRALIA HOSPITAL PT |
| Practice Address |
914 S Scheuber Rd Centralia WA 98531-9027 |
| Practice Telephone | 3607362803 |
| Mailing Telephone | 3607362803 |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2007-10-21 |
| Authorized Official Name | MR. THOMAS RISSE (CFO SWSA REGION) |
| Authorized Official Telephone | 3604935701 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273Y00000X | Rehabilitation Unit | WA | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7061559 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Centralia Hospital PT | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154451714 | Providence Health System Washington | Pharmacy | 920 Compassion Cir, Anchorage, AK 99504-1645 | 2007-03-06 |
| Street Address |
914 S SCHEUBER RD |
| City | CENTRALIA |
| State | WA |
| Zip Code | 98531-9027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982600805 | Leena Carriere | Anesthesiology | 914 S Scheuber Rd, Pmg Sw Wa Centralia Anesthesiology, Centralia, WA 98531-9027 | 2005-06-24 |
| 1114542065 | Gary John Clinton Mersereau Sr. | Registered Nurse | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2020-06-16 |
| 1366077745 | Andrew J Maasdam | Nurse Anesthetist, Certified Registered | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2020-03-06 |
| 1447884374 | Michelle Stover | Registered Nurse | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2020-02-29 |
| 1932748993 | Erika Anne Laurentz | Counselor | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2019-12-22 |
| 1952942567 | Ashley Marie Wheeler | Emergency Medicine | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2019-10-04 |
| 1619537057 | Rebecca Kathryn Mcneil | Counselor | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2019-06-18 |
| 1982269395 | Jennifer Green | Physician Assistant | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2019-05-01 |
| 1033698519 | Jennifer Ann Reuter | Physician Assistant | 914 S Scheuber Rd, Centralia, WA 98531 | 2018-08-07 |
| 1629554274 | Rachelle Marie Peterson | Occupational Therapist | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2018-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306462205 | Jelisa Renae Thomas | Counselor | 3510 Steelhammer Ln, Centralia, WA 98531 | 2020-06-17 |
| 1205498607 | Jennifer Kristine Mcglynn Paterno | Counselor | 2428 W. Reynods Ave, Centralia, WA 98531 | 2019-07-05 |
| 1538646328 | Adam Jeffrey Moore | Counselor | 3510 Steelhammer Lane, Centralia, WA 98531 | 2018-07-24 |
| 1144706698 | Euijeong Kim | Occupational Therapist | Rehabilitation Therapies, 914 S. Scheuber Rd, Centralia, WA 98531 | 2018-07-18 |
| 1104315266 | Margaret Fowler Floyd | Registered Nurse | Centralia High School, 813 Eshom Road, Centralia, WA 98531 | 2018-05-04 |
| 1124545777 | Samantha Michelle Moody | Speech-Language Pathologist | Centralia School District, 2320 Borst Ave, Centralia, WA 98531 | 2017-08-24 |
| 1821520289 | Alexa Franks | Behavior Technician | 2428 West Reynolds Ave., Centralia, WA 98531 | 2017-04-03 |
| 1023559861 | Brandy Michelle Peterson | Counselor | 135 W. Main Steet, Centralia, WA 98531 | 2017-03-13 |
| 1841738812 | Graceful Healing Naturopathic | Naturopath | 219 N Tower Ave, Suite 304, Centralia, WA 98531 | 2017-02-09 |
| 1043681513 | Angela Naillon | Counselor | 2428 West Reynolds, Centralia, WA 98531 | 2015-10-09 |
| Find all providers in zip 98531 | ||||
| Taxonomy Code | 273Y00000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation Unit |
| In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. |
| Notes: Source: Code of Federal Regulations #42, Section 412.29. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275682932 | Providence Health & Services Washington | Rehabilitation Unit | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437575982 | Suzette Gurtisen, Lmp | Rehabilitation Unit | 4763 Poppy St, West Richland, WA 99353-7770 | 2014-03-07 |
| 1407055759 | Providence Health & Services Washington | Rehabilitation Unit | 410 Providence Ln., Building 2, Olympia, WA 98506-5101 | 2007-07-17 |
| 1225230980 | Columbia Basin Physical Therapy Inc. Ps | Rehabilitation Unit | 1075 Basin St Sw, Ephrata, WA 98823-2041 | 2007-06-04 |
| 1083672273 | Peacehealth | Rehabilitation Unit | 809 E Chestnut St, Bellingham, WA 98225-5221 | 2006-05-04 |
| 1972507580 | Kadlec Regional Medical Center | Rehabilitation Unit | 888 Swift Blvd, Richland, WA 99352 | 2005-06-10 |
| 1790319580 | Kadlec Regional Medical Center | Rehabilitation Unit | 888 Swift Blvd, Richland, WA 99352-3514 | 2020-03-02 |
| 1548734205 | Peacehealth Southwest Medical Center | Rehabilitation Unit | 400 Ne Mother Joseph Pl, Vancouver, WA 98664-3200 | 2019-01-16 |
| 1861995714 | Peacehealth United General Medical Center | Rehabilitation Unit | 2000 Hospital Dr, Sedro Woolley, WA 98284-4327 | 2018-03-16 |
| 1437677671 | Shc Medical Center - Yakima | Rehabilitation Unit | 110 S 9th Ave, Yakima, WA 98902-3315 | 2017-09-08 |
| 1558601195 | Seattle Spine and Rehabilitation | Rehabilitation Unit | 3213 Eastlake Ave E, Seattle, WA 98102-7127 | 2013-02-19 |
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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.