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LINCOLN COUNTY HOSPITAL DISTRICT #3 / NORTH BASIN MEDICAL CLINICS
NPI 1053527853
Family Medicine in Davenport, WA

Active since May 16, 2007
10 NICHOLLS ST, DAVENPORT, WA 99122(509) 725-7501(509) 725-7504 Get Directions Write a Review

NPPES record last updated: June 8, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Lincoln County Hospital District #3 / North Basin Medical Clinics NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LINCOLN COUNTY HOSPITAL DISTRICT #3 / NORTH BASIN MEDICAL CLINICS (NPI 1053527853), doing business as North Basin Medical Clinics, is a healthcare organization registered as a family medicine in Davenport, Washington and active in the NPI registry since May 2007. The organization lists Tyson E Lacy, Ceo, as its authorized official.

NPPES Registry Identity

NPI1053527853
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLINCOLN COUNTY HOSPITAL DISTRICT #3 / NORTH BASIN MEDICAL CLINICS
Location Address10 NICHOLLS STDavenport, WA 99122-9729
Mailing Address10 Nicholls StDavenport, WA 99122-9729 · (509) 725-7501 · Fax (509) 725-7504
Phone(509) 725-7501
Fax(509) 725-7504
Organization SubpartYesParent: Lincoln County Hospital District 3
Authorized OfficialTyson E LacyCeo · (509) 725-2979
Enumeration DateMay 16, 2007
Last NPPES UpdateJune 8, 2026
NPPES CertifiedJune 8, 2026
✔ NPI 1053527853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
Also ListedSurgeryTaxonomy 208600000X
10 NICHOLLS ST, Davenport, WA 99122
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Other Names 1

Doing Business AsNorth Basin Medical Clinics

Other Identifiers 3

Medicaid7117450WA
OtherCJ6525WA · Medicare Railroad
Medicaid7101132WA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lincoln County Hospital District #3 / North Basin Medical Clinics is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

19

Medicare enrollment records show 19 clinicians reassign Medicare billing to Lincoln County Hospital District #3 / North Basin Medical Clinics, which bills Medicare for the services they deliver. Of these, 14 practice at this address and 15 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 10

Family Practice6
Nurse Practitioner3
Certified Registered Nurse Anesthetist (CRNA)2
Clinical Social Worker2
Emergency Medicine1
Endocrinology1
General Surgery1
Hospitalist1
2 other specialties2

Clinicians, nearest first (19)

Po-Lun Chou, MD
Hospitalist
NPI 1225617780
10 NICHOLLS ST
Davenport, WA 99122
(214) 596-8014
✔ PECOS✔ Accepts MedicareSame address
James Dunlap, M.D.
Orthopedic Surgery
NPI 1740256759
10 NICHOLLS ST
Davenport, WA 99122
(509) 725-6560
✔ PECOS✔ Accepts MedicareSame address
Amy Hiestand, NP
Nurse Practitioner
NPI 1124140116
10 NICHOLLS ST
Davenport, WA 99122
(509) 725-7101
✔ PECOS✔ Accepts MedicareSame address
Karen Keith, LCSW
Clinical Social Worker
NPI 1992215388
10 NICHOLLS ST
Davenport, WA 99122
(509) 725-7501
✔ PECOS✔ Accepts MedicareSame address
Janell Long, ARNP
Nurse Practitioner
NPI 1912632381
10 NICHOLLS ST
Davenport, WA 99122
(509) 725-7501
✔ PECOS✔ Accepts MedicareSame address
Chad Mongrain, DO
Family Practice
NPI 1720028244
10 NICHOLLS ST
Davenport, WA 99122
(509) 725-7501
✔ PECOS✔ Accepts MedicareSame address
Karl Olson, MD
Emergency Medicine
NPI 1508846353
10 NICHOLLS ST
Davenport, WA 99122
(509) 725-7501
✔ PECOS✔ Accepts MedicareSame address
Rolf Panke, DO
Family Practice
NPI 1396782272
10 NICHOLLS ST
Davenport, WA 99122
(509) 725-7501
✔ PECOS✔ Accepts MedicareSame address
Amanda Rafter, D.O
Internal Medicine
NPI 1700222890
10 NICHOLLS ST
Davenport, WA 99122
(509) 725-7101
✔ PECOS✔ Accepts MedicareSame address
Frederick Reed, M.D.
Family Practice
NPI 1467411157
10 NICHOLLS ST
Davenport, WA 99122
(509) 725-7501
✔ PECOS✔ Accepts MedicareSame address
Raaj Ruparel, MD
General Surgery
NPI 1174819593
10 NICHOLLS ST
Davenport, WA 99122
(509) 725-6560
✔ PECOS✔ Accepts MedicareSame address
Paul Travis, DNP, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1346732633
10 NICHOLLS ST
Davenport, WA 99122
(509) 725-7101
✔ Accepts MedicareSame address
Benjamin Wainblat, MD
Family Practice
NPI 1205491164
10 NICHOLLS ST
Davenport, WA 99122
(509) 725-7101
✔ PECOS✔ Accepts MedicareSame address
Kara Wesebaum, LCSW
Clinical Social Worker
NPI 1114410073
10 NICHOLLS ST
Davenport, WA 99122
(509) 725-7501
✔ PECOS✔ Accepts MedicareSame address
Donella Young, MD
Family Practice
NPI 1073554119
100 3RD ST SUITE 1
Davenport, WA 99122
(509) 725-7501
✔ PECOS0.1 mi
Brian Yoon, ARNP
Nurse Practitioner
NPI 1841790268
550 E BROADWAY AVE
Reardan, WA 99029
(509) 796-2737
✔ PECOS✔ Accepts Medicare13 mi
Lynn Kohlmeier, M.D.
Endocrinology
NPI 1528026820
6506 S DEVONSHIRE CT
Spokane, WA 99223
(509) 998-1045
✔ PECOS35 mi
Steven Beckstrom, CRNA, MAE
Certified Registered Nurse Anesthetist (CRNA)
NPI 1316033210
12509 E MISSION AVE STE 101
Spokane Valley, WA 99216
(509) 928-3600
✔ Accepts Medicare42 mi
Dean Kubacz, MD
Family Practice
NPI 1023276896
423 N THIRD AVE
Sandpoint, ID 83864
(208) 263-1441
✔ PECOS✔ Accepts Medicare85 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lincoln County Hospital District #3 / North Basin Medical Clinics's NPI number?

The NPI number for Lincoln County Hospital District #3 / North Basin Medical Clinics is 1053527853. It was assigned to this organization in the NPPES registry on May 16, 2007. The provider is doing business as North Basin Medical Clinics.

Where is Lincoln County Hospital District #3 / North Basin Medical Clinics located?

Lincoln County Hospital District #3 / North Basin Medical Clinics is located at 10 Nicholls St, Davenport, WA 99122. The listed phone number is (509) 725-7501.

What is Lincoln County Hospital District #3 / North Basin Medical Clinics's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Lincoln County Hospital District #3 / North Basin Medical Clinics enrolled in Medicare?

Yes. Lincoln County Hospital District #3 / North Basin Medical Clinics is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lincoln County Hospital District #3 / North Basin Medical Clinics?

According to the CMS Revalidation Reassignment List (October 2026 release), 19 clinicians in 10 Medicare specialties reassign their Medicare billing to Lincoln County Hospital District #3 / North Basin Medical Clinics. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (6), Nurse Practitioner (3) and Certified Registered Nurse Anesthetist (CRNA) (2). Of these, 14 practice at this address and 15 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Lincoln County Hospital District #3 / North Basin Medical Clinics accept?

Health plans from Ambetter Health list Lincoln County Hospital District #3 / North Basin Medical Clinics as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lincoln County Hospital District #3 / North Basin Medical Clinics was last updated on June 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.