SOUTHWEST IDAHO ADVANCED CARE HOSPITAL INC -A DELAWARE CORP- (NPI# 1114112216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114112216 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST IDAHO ADVANCED CARE HOSPITAL INC -A DELAWARE CORP- |
| Practice Address |
6651 W Franklin Rd Boise ID 83709 |
| Practice Telephone | 5058565300 |
| Mailing Telephone | 5058565300 |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2017-08-17 |
| Authorized Official Name | CLAUDE DARBY BROCKETTE (CEO) |
| Authorized Official Telephone | 5058565300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 282E00000X | Long Term Care Hospital | Hospitals |
| Street Address |
6651 W FRANKLIN RD |
| City | BOISE |
| State | ID |
| Zip Code | 83709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427081744 | Tara Erbele | Family Medicine | 6651 W Franklin Rd, Boise, ID 83709-0914 | 2006-07-09 |
| 1275912305 | Monica Million | Registered Nurse | 6651 W Franklin Rd, Boise, ID 83709-0914 | 2015-05-21 |
| 1639514094 | Vibra Hospital of Boise LLC | Long Term Care Hospital | 6651 W Franklin Rd, Boise, ID 83709-0914 | 2013-04-30 |
| 1730405721 | Huiling Qi | Internal Medicine | 6651 W Franklin Rd, Boise, ID 83709-0914 | 2010-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427655398 | Jayme Rossow | Occupational Therapist | 101 S. Allumbaugh Way, Boise, ID 83709 | 2020-10-05 |
| 1578195285 | Kara Taylor | Counselor | 9196 W Barnes St., Boise, ID 83709 | 2020-02-11 |
| 1164080164 | Elena Stamm | Audiologist | 10000 W Amity Rd, Boise, ID 83709 | 2019-06-04 |
| 1326550096 | Lawrence D Anderson Md Estate | Optometrist | 8955 W Hackamore Dr, Boise, ID 83709 | 2017-11-02 |
| 1457879975 | Mark Aaron Phelan | Registered Nurse | 779 S. Tennyson Way, Boise, ID 83709 | 2017-09-05 |
| 1235665290 | Sharon Nelson | Dietitian, Registered | 2790 S Goshen Way, Boise, ID 83709 | 2017-05-11 |
| 1982139622 | First Choice Healthcare, Inc. | Home Health | 12400 W. Overland Rd., Ste 100, Boise, ID 83709 | 2017-05-01 |
| 1801320254 | Deborah Carson | Social Worker | 8349 West Harmonica Way, Boise, ID 83709 | 2017-04-12 |
| 1114479862 | Allyson Anne Bates | Nurse Practitioner | 10583 W Lake Hazel Road, Samg Family Medicine, Boise, ID 83709 | 2016-10-28 |
| 1508221391 | Elisha L. Garrison | Counselor | 9196 W. Barnes Street, Boise, ID 83709 | 2015-12-21 |
| Find all providers in zip 83709 | ||||
| Taxonomy Code | 282E00000X |
| Grouping | Hospitals |
| Classification | Long Term Care Hospital |
| Long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions. |
| Notes: Source: American Hospital Association [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639514094 | Vibra Hospital of Boise LLC | Long Term Care Hospital | 6651 W Franklin Rd, Boise, ID 83709-0914 | 2013-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023079092 | Northern Idaho Advanced Care Hospital Inc | Long Term Care Hospital | 600 N Cecil Rd, Post Falls, ID 83854-6200 | 2006-03-30 |
| 1639211634 | St. Benedicts Family Medical Center | Long Term Care Hospital | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2007-02-13 |
| 1245371863 | St Lukes Regional Medical Center | Long Term Care Hospital | 895 N 6th E, Mtn Home, ID 83647-2207 | 2007-02-08 |
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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.