Provider Demographics
| NPI: | 1730139510 |
|---|---|
| Name: | YAKIMA HMA PHYSICIAN MANAGEMENT LLC |
| Entity Type: | Organization |
| Organization Name: | YAKIMA HMA PHYSICIAN MANAGEMENT LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | SR. DIRECTOR |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | JAMES |
| Authorized Official - Middle Name: | PATRICK |
| Authorized Official - Last Name: | WRIGHT |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 615-465-7587 |
| Mailing Address - Street 1: | PO BOX 689022 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | FRANKLIN |
| Mailing Address - State: | TN |
| Mailing Address - Zip Code: | 37068-9022 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 615-778-8530 |
| Mailing Address - Fax: | 615-465-2896 |
| Practice Address - Street 1: | 110 S 9TH AVE |
| Practice Address - Street 2: | |
| Practice Address - City: | YAKIMA |
| Practice Address - State: | WA |
| Practice Address - Zip Code: | 98902-3315 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 509-574-4455 |
| Practice Address - Fax: | 509-574-4481 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | HEALTH MANAGEMENT ASSOCIATES, INC. |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2006-05-11 |
| Last Update Date: | 2016-01-21 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
| No | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | Group - Multi-Specialty | |
| No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 2083X0100X | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine | Group - Multi-Specialty |
| No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 2086S0129X | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | Group - Multi-Specialty |
| No | 208VP0000X | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | Group - Multi-Specialty |
| No | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| WA | 7131162 | Medicaid | |
| WA | 7117849 | Medicaid | |
| WA | 7117948 | Medicaid | |
| WA | 7135171 | Medicaid | |
| WA | 7128572 | Medicaid | |
| WA | 7134596 | Medicaid | |
| WA | 7121924 | Medicaid | |
| WA | 7117831 | Medicaid | |
| WA | 7124886 | Medicaid | |
| WA | 7117955 | Medicaid | |
| WA | G8800116 | Medicare PIN |
