MINIDOKA MEMORIAL HOSPITAL (NPI# 1205870219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205870219 |
| Entity Type | Organization |
| Organization Name | MINIDOKA MEMORIAL HOSPITAL |
| Other Organization Name | MINIDOKA HOME HEALTH |
| 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 | 2006-06-16 |
| Last Update Date | 2016-01-19 |
| Authorized Official Name | THOMAS J MURPHY (ADMINISTRATOR) |
| Authorized Official Telephone | 2084368141 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | HHH154 | ID | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS | 02469 | 01 |
| ID | M8063733 | 05 | |
| ID | BLUE SHIELD | 000010006548 | 01 |
| ID | BLUE SHIELD HOSPICE | 000010033865 | 01 |
| ID | M0023367 | 05 |
| Other Name | Type Code |
|---|---|
| Minidoka Home Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043387426 | Minidoka Memorial Hospital | Clinic/Center | 1308 8th St, Suite 1, Rupert, ID 83350-1530 | 2006-11-29 |
| 1134333495 | Minidoka Memorial Hospital | Clinic/Center | 1224 8th St, Rupert, ID 83350-1527 | 2007-05-09 |
| 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 |
| 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 |
| 1134333495 | Minidoka Memorial Hospital | Clinic/Center | 1224 8th St, Rupert, ID 83350-1527 | 2007-05-09 |
| 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 |
| 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 | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669872057 | Greenbrier County Committee On Aging | Home Health | 284 Greenbrier Street, Rupert, WV 25984 | 2014-09-04 |
| 1497898456 | Greenbrier County Committee On Aging, Inc. | Home Health | 1003 Greenbrier Street, Rupert, WV 25984 | 2007-02-15 |
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|---|---|---|---|---|
| 1912511213 | Irene M Ohls | Home Health | 322 W Logan St, Caldwell, ID 83605-1710 | 2020-09-03 |
| 1881202414 | Ann Chambers | Home Health | 1320 Dry Creek Rd, Troy, ID 83871-9664 | 2020-07-20 |
| 1720602816 | Ann Home Care LLC | Home Health | 42565 Silver Valley Rd, Kingston, ID 83839-9736 | 2020-06-03 |
| 1477177921 | Whitewater Healthcare LLC | Home Health | 240 W Burnside Ave Ste B, Chubbuck, ID 83202-4703 | 2020-06-01 |
| 1003436171 | Right At Home Care | Home Health | 158 E Main St Ste 4b, Grangeville, ID 83530-2283 | 2020-04-20 |
| 1467097410 | Karissa I Niece | Home Health | 3515 W Greenbrier Dr, Boise, ID 83705-4514 | 2019-11-14 |
| 1639714967 | Summerlin Healthcare, Inc. | Home Health | 1675 E Riverside Dr Ste 150, Eagle, ID 83616-7584 | 2019-11-11 |
| 1033768262 | Cloudnine Home Care LLC | Home Health | 482 Constitution Way Ste 110, Idaho Falls, ID 83402-3568 | 2019-09-10 |
| 1164082210 | Boise Home Care Inc. Comfort Keepers | Home Health | 7646 W Lemhi St Ste 4, Boise, ID 83709-2871 | 2019-06-19 |
| 1477111276 | Perfection Home Health LLC | Home Health | 1190 Quigley St Ste A, Idaho Falls, ID 83402-1812 | 2019-06-05 |
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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.