MINIDOKA MEMORIAL HOSPITAL (NPI# 1134333495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134333495 |
| Entity Type | Organization |
| Organization Name | MINIDOKA MEMORIAL HOSPITAL |
| Other Organization Name | MMH PHYSICIANS |
| Practice Address |
1224 8th St Rupert ID 83350-1527 |
| Practice Telephone | 2084360481 |
| Practice Fax Number | 2084366038 |
| Mailing Telephone | 2084360481 |
| Mailing Fax Number | 2084366038 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2015-12-09 |
| Authorized Official Name | THOMAS J MURPHY (ADMINISTRATOR) |
| Authorized Official Telephone | 2084360481 |
| Is Organization Subpart | Y |
| Parent Organization Name | MINIDOKA MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0002X |
Clinic/Center Specialization: Emergency Care |
26 | ID | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE SHIELD ER | 00010006547 | 01 |
| ID | BLUE CROSS ER | 8D418 | 01 |
| ID | M0023361 | 05 |
| Other Name | Type Code |
|---|---|
| MMH Physicians | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043387426 | Minidoka Memorial Hospital | Clinic/Center | 1308 8th St, Suite 1, Rupert, ID 83350-1530 | 2006-11-29 |
| 1942364070 | Minidoka Memorial Hospital | Pharmacy | 1224 8th St, Rupert, ID 83350-1527 | 2006-12-21 |
| 1023052040 | Minidoka Memorial Hospital | Skilled Nursing Facility | 1224 8th St, Rupert, ID 83350-1527 | 2006-06-16 |
| 1205870219 | Minidoka Memorial Hospital | Home Health | 1224 8th St, Rupert, ID 83350-1527 | 2006-06-16 |
| 1679553531 | Minidoka Memorial Hospital | Medicare Defined Swing Bed Unit | 1224 8th St, Rupert, ID 83350-1527 | 2006-01-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MINIDOKA MEMORIAL HOSPITAL | 1224 8th St, Rupert, ID 83350-1527 |
| Street Address |
1224 8TH ST |
| City | RUPERT |
| State | ID |
| Zip Code | 83350-1527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306836077 | Donald J Konrad | Family Medicine | 1224 8th St, Rupert, ID 83350-1527 | 2005-10-25 |
| 1215432984 | Rachel D Durrant | Speech-Language Pathologist | 1224 8th St, Rupert, ID 83350-1527 | 2018-03-26 |
| 1972763381 | Benjamin Guercio | Nurse Anesthetist, Certified Registered | 1224 8th St, Rupert, ID 83350-1527 | 2008-06-10 |
| 1073787784 | Minidoka Memorial Hospital Crna Group | Nurse Anesthetist, Certified Registered | 1224 8th St, Rupert, ID 83350-1527 | 2008-04-15 |
| 1225202922 | Minidoka Memorial Hospital Ambulance | Ambulance | 1224 8th St, Rupert, ID 83350-1527 | 2008-04-15 |
| 1942364070 | Minidoka Memorial Hospital | Pharmacy | 1224 8th St, Rupert, ID 83350-1527 | 2006-12-21 |
| 1669578472 | Lori Johnson | Dietitian, Registered | 1224 8th St, Rupert, ID 83350-1527 | 2006-09-16 |
| 1205855202 | Jeffery D. Baldwin | Physical Therapist | 1224 8th St, Suite A, Rupert, ID 83350-1527 | 2006-07-19 |
| 1730104597 | Maria E. Hernandez | Physical Therapist | 1224 8th St, Suite A, Rupert, ID 83350-1527 | 2006-07-13 |
| 1023052040 | Minidoka Memorial Hospital | Skilled Nursing Facility | 1224 8th St, Rupert, ID 83350-1527 | 2006-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417349515 | Robbie Joe Carroll | Registered Nurse | 1024 8th Street, Family Health Services, Rupert, ID 83350 | 2015-02-26 |
| 1285921643 | Duane Broderick | Counselor | 2311 Parke Ave., Ste. 8, Burley, ID 83350 | 2011-07-06 |
| 1598798282 | Kerry W Saurey | Family Medicine | 1218 9th St, Ste 7, Rupert, ID 83350 | 2006-07-08 |
| 1093761694 | Family Health Services Corporation | Dental Hygienist | 402 6th St, Rupert, ID 83350 | 2006-05-25 |
| 1376531004 | Jeffrey Scott Swenson | Family Medicine | 1308 8th St Ste 1, Rupert, ID 83350 | 2005-10-06 |
| 1205312774 | Shawna M Mccaffrey | Nurse Practitioner | 1308 8th St, Rupert, ID 83350 | 2018-07-17 |
| 1386872810 | Brian R Muir | Family Medicine | 1308 8th St Ste 1, Rupert, ID 83350 | 2009-06-23 |
| 1083816334 | Cameron Mchan | Nurse Practitioner | 1308 8th St Ste 1, Rupert, ID 83350 | 2007-05-31 |
| 1134225956 | Margo Saunders | Specialist | 1308 8th St Ste 1, Rupert, ID 83350 | 2006-09-16 |
| 1619900305 | Don C Pates | Family Medicine | 1218 9th St, Ste 7, Rupert, ID 83350 | 2006-07-08 |
| Find all providers in zip 83350 | ||||
| Taxonomy Code | 261QE0002X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Emergency Care |
| Definition to come... |
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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.