North Basin Medical Clinics--Reardan Clinic – Rural Health Clinic/Center, NPI 1639113830

North Basin Medical Clinics--Reardan Clinic is a healthcare provider. based in Davenport, Washington. specializing in Rural Health Clinic/Center. The organization holds a License No. H-137 (WA). The NPI Number for North Basin Medical Clinics--Reardan Clinic is 1639113830

Main info

Organization
Name
North Basin Medical Clinics--Reardan Clinic
NPI
1639113830
Phone
(509) 725-7501
Address
100 3RD ST
Authorized Official
TYSON E LACY CEO, ADMINISTRATOR
Enumeration Date
16 June 2006
Last Update Date
26 February 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness90
Years active:19State licenses:1Digital endpoints

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Provider Addresses for North Basin Medical Clinics--Reardan Clinic

  • 100, 3rd Street, Davenport, Cass County, North Dakota, 58021, United States

    SUITE 1

    DAVENPORT, WA 991229730

    Phone: (509) 725-7501

    Fax: (509) 725-7504

    Type: Mailing

  • 10 NICHOLLS ST

    DAVENPORT, WA 991229729

    Phone: (509) 725-7501

    Fax: (509) 725-7504

    Type: Mailing

  • 550 E BROADWAY AVE

    REARDAN, WA 99029

    Phone: (509) 796-2737

    Fax: (509) 796-2738

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-05-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040505000483OClinic/Group PracticeWATBD
O20080512000523ORural Health ClinicWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99122)

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Reviews

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Frequently asked questions

How is North Basin Medical Clinics--Reardan Clinic identified in CMS data?
CMS-hosted NPPES data lists North Basin Medical Clinics--Reardan Clinic with NPI 1639113830.
Does the file indicate North Basin Medical Clinics--Reardan Clinic is practicing under active NPI?
Directory data currently reports North Basin Medical Clinics--Reardan Clinic as active.
What healthcare role does North Basin Medical Clinics--Reardan Clinic hold?
Scheduling teams often label North Basin Medical Clinics--Reardan Clinic under Rural Health Clinic/Center. Clinical services aligned with this taxonomy classification.
Where should I expect North Basin Medical Clinics--Reardan Clinic on a map?
Expect Davenport, Washington as a primary anchor for North Basin Medical Clinics--Reardan Clinic unless the record lists multiple sites.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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