BLUE MOUNTAIN FAMILY HEALTH
NPI 1679649248
Family Medicine in Clarkston, WA
About Blue Mountain Family Health NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLUE MOUNTAIN FAMILY HEALTH (NPI 1679649248) is a healthcare organization registered as a family medicine in Clarkston, Washington and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Kevin James Black, Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 4
Group Practice 1
Accepted 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)
Blue Mountain Family Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Blue Mountain Family Health, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 50D1045822
Blue Mountain Family Health · Clarkston, WAFrequently 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 Blue Mountain Family Health PLLC's NPI number?
The NPI number for Blue Mountain Family Health PLLC is 1679649248. It was assigned to this organization in the NPPES registry on November 27, 2006. The provider is doing business as Blue Mountain Family Health.
Where is Blue Mountain Family Health PLLC located?
Blue Mountain Family Health PLLC is located at 1268 Bridge St, Clarkston, WA 99403. The listed phone number is (509) 751-5500.
What is Blue Mountain Family Health PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Blue Mountain Family Health PLLC enrolled in Medicare?
Yes. Blue Mountain Family Health PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Blue Mountain Family Health PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Blue Mountain Family Health PLLC, in Family Practice and Nurse Practitioner. 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Blue Mountain Family Health PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 50D1045822) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Blue Mountain Family Health PLLC accept?
Health plans from Ambetter Health and Premera Blue Cross Blue Shield of Alaska list Blue Mountain Family Health PLLC 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 Blue Mountain Family Health PLLC was last updated on May 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Blue Mountain Family Health · NPI 1679649248
Family Medicine organization in Clarkston, Washington. Organization record, active in the CMS NPPES registry since November 27, 2006.
## Identity
- **NPI:** 1679649248 (Entity type: Organization)
- **Enumerated:** November 27, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Blue Mountain Family Health Pllc
- **Organization subpart:** No
- **Authorized official:** Kevin Black, ADMINISTRATOR
## Practice location
- **Address:** 1268 BRIDGE ST, Clarkston, WA 99403-2219
- **Phone:** (509) 751-5500 · **Fax:** (509) 751-1059
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Nurse Practitioner (1); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 21, 2024
- **Other identifiers:** Medicaid 7130354 (WA); Medicaid 807278700 (ID); Medicaid 80745000 (ID); and 1 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1679649248) · Data from the CMS NPPES public registry.