ST. MARY'S HOSPITAL (NPI# 1174577100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174577100 |
| Entity Type | Organization |
| Organization Name | ST. MARY'S HOSPITAL |
| Other Organization Name | ST. MARY'S COTTONWOOD CLINIC |
| Practice Address |
701 Lewiston St Cottonwood ID 83522-9750 |
| Mailing Address |
Po Box 565 Cottonwood ID 83522-0565 |
| Practice Telephone | 2089623267 |
| Practice Fax Number | 2089622313 |
| Mailing Telephone | 2089623267 |
| Mailing Fax Number | 2089622313 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2020-10-02 |
| Authorized Official Name | MICHELLE M GATES (DIRECTOR OF REVENUE CYCLE) |
| Authorized Official Telephone | 2084768083 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | ID | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 207Q00000X | Family Medicine | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 805066400 | 05 | |
| ID | 002283500 | 05 |
| Other Name | Type Code |
|---|---|
| St. Mary's Cottonwood Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992931232 | St. Mary's Hospital | Early Intervention Provider Agency | 9226 Avenue J, Brooklyn, Brooklyn, NY 11236-3935 | 2009-06-01 |
| 1932333994 | St. Mary's Hospital | Physical Therapist | 619 4th St, Kamiah, ID 83636 | 2009-05-06 |
| 1427261007 | St. Mary's Hospital | General Acute Care Hospital | 365 Harding Ave, Apt. 2, Clifton, NJ 07011-3626 | 2007-05-08 |
| 1578684023 | St. Mary's Hospital | Community Based Residential Treatment Facility, Mental Illness | 530 Main Ave, Passaic, NJ 07055-5700 | 2007-04-03 |
| 1750402202 | St. Mary's Hospital | Residential Treatment Facility, Emotionally Disturbed Children | 33 Mineral Spring Ave, Passaic, NJ 07055-2512 | 2007-04-03 |
| 1366480394 | St. Mary's Hospital | Nurse Practitioner | 501 Oak, Nezperce, ID 83543 | 2006-06-03 |
| 1568400562 | St. Mary's Hospital | Nurse Practitioner | 518 Oak, Kamiah, ID 83536 | 2006-06-02 |
| 1770521817 | St. Mary's Hospital | Nurse Practitioner | 320 N Division, Craigmont, ID 83523 | 2006-06-02 |
| 1285630624 | St. Mary's Hospital | Clinic/Center | 205 Huron, Irvington, IL 62848 | 2005-06-21 |
| 1790789451 | St. Mary's Hospital | Clinic/Center | 825 New York Dr, Ste 2, Vandalia, IL 62471-1044 | 2005-06-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL FOR CHILDREN, INC. | 2901 216th St, Bayside, NY 11360-2810 |
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL MEDICAL CENTER | 700 S Park St, Madison, WI 53715-1849 |
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL OF SUPERIOR | 3500 Tower Ave, Superior, WI 54880-5335 |
| Colorado Business Entities | St. Mary's Hospital & Medical Center Medical Staff | 2635 N 7th St, Grand Junction, CO 81501 |
| Washington State Corporations | ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. | 500 Eldorado Blvd Ste 4300, Attn Chief Legal Officer, Broomfield, CO 80021 |
| Colorado Business Entities | ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. | 2635 N. 7th Street, Grand Junction, CO 81501 |
| Colorado Business Entities | ST. MARY'S HOSPITAL FOUNDATION | 2635 N 7th Street, Grand Junction, CO 81501 |
| System for Award Management (SAM) Entities | ST. MARY'S HOSPITAL FOUNDATION | 2635 N 7th St, Grand Junction, CO 81501-8209 |
| System for Award Management (SAM) Entities | ST. MARY'S HOSPITAL LACOR | Juba Road, Gulu, , UGA |
| Massachusetts Corporations | ST. MARY'S HOSPITAL, INC. | 901 45th St., W. Palm Beach, FL 33416 |
| Street Address |
701 LEWISTON ST |
| City | COTTONWOOD |
| State | ID |
| Zip Code | 83522-9750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316940232 | Haley J Minnehan | Family Medicine | 701 Lewiston St, Cottonwood, ID 83522-9750 | 2005-05-24 |
| 1558995829 | Patrick Ross Hulan | Physical Therapist | 701 Lewiston St, Cottonwood, ID 83522-9750 | 2020-02-26 |
| 1356794721 | Kevin Lienesch | Nurse Anesthetist, Certified Registered | 701 Lewiston St, Cottonwood, ID 83522-9750 | 2016-07-20 |
| 1740639541 | Justin Leroy Jones | Family Medicine | 701 Lewiston St, Cottonwood, ID 83522-9750 | 2016-06-13 |
| 1164759379 | Rebecca S Kirk-ewing | Registered Nurse | 701 Lewiston St, Cottonwood, ID 83522-9750 | 2009-11-09 |
| 1851556229 | Clarence Jaron Brunson | Chiropractor | 701 Lewiston St, Cottonwood, ID 83522-9750 | 2008-07-24 |
| 1992994024 | St. Mary's Hospital Pharmacy | Pharmacy | 701 Lewiston St, Cottonwood, ID 83522 | 2007-10-15 |
| 1245433739 | St. Mary's Hospital | Nurse Anesthetist, Certified Registered | 701 Lewiston St, Cottonwood, ID 83522 | 2007-06-11 |
| 1003948845 | Bernadette Jamie Rundhaug | Counselor | 701 Lewiston St, Cottonwood, ID 83522 | 2007-03-09 |
| 1114076635 | Richard A Erickson | Nurse Anesthetist, Certified Registered | 701 Lewiston St, Cottonwood, ID 83522 | 2007-01-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689084659 | Denise Marie Nuxoll | Pharmacist | 429 Main, Cottonwood, ID 83522 | 2014-04-30 |
| 1376711416 | Sherry Lynn Riener | Midwife | 502 King Street, Cottonwood, ID 83522 | 2008-02-12 |
| 1629114905 | Cottonwood Jt Sch Dist | Local Education Agency (LEA) | 907 Lewiston Street, Cottonwood, ID 83522 | 2007-01-30 |
| 1902980121 | Arnzen Super Drug, Inc. | Pharmacy | 429 Main Street, Cottonwood, ID 83522 | 2006-10-24 |
| 1629047931 | John Douglas Trueblood | Physician Assistant | 701 Lewiston Street, Cottonwood, ID 83522 | 2006-03-17 |
| 1124442421 | Carletta Jean Allen | Speech-Language Pathologist | 701 Lewiston Street, Cottonwood, ID 83522 | 2014-02-07 |
| 1376965319 | Jamie Scheffler | Physical Therapist | 701 Lewiston Street, Cottonwood, ID 83522 | 2014-01-10 |
| 1639482888 | Scarlett Jo Uhlenkott | Nurse Practitioner | 701 Lewiston Street, Cottonwood, ID 83522 | 2010-07-16 |
| 1457665945 | Providence Health & Services | Internal Medicine | 701 Lewiston Street, Cottonwood, ID 83522-0000 | 2010-07-27 |
| 1053309971 | Obbie T Atkinson | Family Medicine | 701 Lewiston Street, Cottonwood, ID 83522-0000 | 2005-10-13 |
| Find all providers in zip 83522 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184982266 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 450 South Willard Street, Cottonwood, AZ 86326 | 2012-04-26 |
| 1154527778 | Laurel A Mueller | Family Medicine | 51 Brian Mickelsen Pkwy, Community Health Center of Yavapai, Cottonwood, AZ 86326 | 2007-06-21 |
| 1407928401 | William C Stonecipher | Family Medicine | 203 S Candy Ln Ste 13a, Cottonwood, AZ 86326-8113 | 2006-11-14 |
| 1497851067 | Malcolm Wilkinson, Md | Family Medicine | 300 S Willard St, Ste 101, Cottonwood, AZ 86326-4159 | 2006-09-14 |
| 1578585519 | Juneau D Stump Jr Md PC | Family Medicine | 18 E Beech St, Cottonwood, AZ 86326-4134 | 2006-07-25 |
| 1790722643 | Curtis G Kommer | Family Medicine | 651 W Mingus Ave, Cottonwood, AZ 86326-4006 | 2006-05-31 |
| 1568454353 | Cottonwood Medical Group | Family Medicine | 20633 Gas Point Rd, Cottonwood, CA 96022-9296 | 2005-08-17 |
| 1336146059 | Marvin L Colvin | Family Medicine | 753 N Main St, Ste. A, Cottonwood, AZ 86326-3649 | 2005-07-07 |
| 1316940232 | Haley J Minnehan | Family Medicine | 701 Lewiston St, Cottonwood, ID 83522-9750 | 2005-05-24 |
| 1740283555 | Andrew F Jones | Family Medicine | 1775 Keuterville Road, Cottonwood, ID 83522-9750 | 2005-05-24 |
| Find all providers in COTTONWOOD | ||||
| City | COTTONWOOD |
| Zip Code | 83522 |
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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.