CARIBOU MEMORIAL HOSPITAL (NPI# 1285970582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285970582 |
| Entity Type | Organization |
| Organization Name | CARIBOU MEMORIAL HOSPITAL |
| Other Organization Name | CARIBOU MEDICAL CLINIC |
| Practice Address |
300 S 3rd W Soda Springs ID 83276-1559 |
| Practice Telephone | 2085473341 |
| Practice Fax Number | 2085470424 |
| Mailing Telephone | 2085473341 |
| Mailing Fax Number | 2085470424 |
| Enumeration Date | 2012-12-14 |
| Last Update Date | 2012-12-14 |
| Authorized Official Name | JOHN HOOPES (CEO) |
| Authorized Official Telephone | 2085473118 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| CARIBOU MEDICAL CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902330830 | Caribou Memorial Hospital | Counselor | 95 E Hooper Ave, Soda Springs, ID 83276-1414 | 2017-04-18 |
| 1801086012 | Caribou Memorial Hospital | Specialist | 300 South 3rd West, Soda Springs, ID 83276 | 2007-07-25 |
| 1912998261 | Caribou Memorial Hospital | General Acute Care Hospital | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2005-11-03 |
| 1154524403 | Caribou Memorial Hospital | Clinic/Center | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2007-06-06 |
| 1750442240 | Caribou Memorial Hospital | Skilled Nursing Facility | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2006-12-12 |
| 1669533154 | Caribou Memorial Hospital | Emergency Medical Technician, Basic | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2006-12-12 |
| 1598825028 | Caribou Memorial Hospital | Medicare Defined Swing Bed Unit | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2006-12-12 |
| Street Address |
300 S 3RD W |
| City | SODA SPRINGS |
| State | ID |
| Zip Code | 83276-1559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912998261 | Caribou Memorial Hospital | General Acute Care Hospital | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2005-11-03 |
| 1619509783 | David C Telford | Physical Therapist | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2020-02-06 |
| 1790244721 | Kevin Courtney Smith | Physical Medicine & Rehabilitation | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2019-03-19 |
| 1467901876 | Aaron Christopher Hobbs | Nurse Practitioner | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2016-09-26 |
| 1184097271 | Ronald Rutten | Physical Therapist | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2015-11-11 |
| 1861770414 | Rmc Management, LLC | Surgery | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2011-08-01 |
| 1548493521 | Brenda Bergholm | Clinical Nurse Specialist | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2009-08-25 |
| 1407000466 | Joshua Reed Torman | Nurse Anesthetist, Certified Registered | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2008-11-04 |
| 1235380072 | Edward Rodney Vangass | Social Worker | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2008-10-09 |
| 1154524403 | Caribou Memorial Hospital | Clinic/Center | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2007-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811390248 | Terry Lee Christensen | Physical Therapy Assistant | 279 E. 3rd N., Soda Springs, ID 83276 | 2014-09-30 |
| 1285049387 | Matthew F Kunz | Dentist | 180 S. Main Street, Soda Springs, ID 83276 | 2014-06-26 |
| 1801086012 | Caribou Memorial Hospital | Specialist | 300 South 3rd West, Soda Springs, ID 83276 | 2007-07-25 |
| 1386681427 | Eron J Evans | Dentist | 390 S 3rd W, Mountain View Dental, Soda Springs, ID 83276 | 2006-05-31 |
| 1154310373 | Jerry H Walker | Dentist | 390 South 3rd West, Soda Springs, ID 83276 | 2005-10-20 |
| 1184022105 | Inner Light Counseling, LLC | Social Worker | 61 E 1st S, Soda Springs, ID 83276 | 2014-12-08 |
| 1710158886 | Mountain View Dental Clinic | Clinic/Center | 390 South 3rd West, Soda Springs, ID 83276 | 2008-03-17 |
| 1730240375 | Sharman Kay Snow | Social Worker | 160 N 1st E, Soda Springs, ID 83276-1203 | 2006-12-13 |
| 1609245612 | Craig Harden Richardson | Specialist/Technologist | 366 N 2nd E, Soda Springs, ID 83276-1218 | 2015-09-20 |
| 1417370388 | Saxton Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 269 N 3rd E, Soda Springs, ID 83276-1226 | 2014-01-29 |
| Find all providers in zip 83276 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992323216 | Wolf Pack LLC | Clinic/Center | 939 S 25th E Ste 115, Ammon, ID 83406-5736 | 2020-07-13 |
| 1831730118 | Falls Medical Aesthetics, Pllc | Clinic/Center | 814 Pancheri Dr, Idaho Falls, ID 83402-3344 | 2019-10-08 |
| 1164072187 | Peter John Leichtnam | Clinic/Center | 1200 W Ironwood Dr Ste 309, Coeur D Alene, ID 83814-2660 | 2019-09-12 |
| 1124674437 | Michael J. Moorhouse Inc. | Clinic/Center | 13900 W Wainwright Dr Ste 100, Boise, ID 83713-5028 | 2019-08-13 |
| 1093368276 | Korena Popp Fnp Medical Services LLC | Clinic/Center | 454 W Roseberry Rd. Ste 104, Donnelly, ID 83615-8361 | 2019-07-17 |
| 1528623915 | D & S Works | Clinic/Center | 5622 W State St, Boise, ID 83703-3010 | 2019-05-01 |
| 1609335090 | Hurst Medical Pllc | Clinic/Center | 1700 Overland Ave Ste 1, Burley, ID 83318 | 2019-03-15 |
| 1912487646 | Ideal Option, Pllc | Clinic/Center | 509 W Hanley Ave Ste 101, Coeur D Alene, ID 83815-8994 | 2018-08-21 |
| 1801376256 | Ideal Option, Pllc | Clinic/Center | 1111 Blue Lakes Blvd N Ste E, Twin Falls, ID 83301-3437 | 2018-08-15 |
| 1649759374 | North Canyon Mountain Home Clinic | Clinic/Center | 840 N 4th E, Mountain Home, ID 83647-2166 | 2018-08-13 |
| Find all providers with the same taxonomy | ||||
| City | SODA SPRINGS |
| Zip Code | 83276 |
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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.