BEAR LAKE COUNTY MEMORIAL HOSPITAL (NPI# 1376871749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376871749 |
| Entity Type | Organization |
| Organization Name | BEAR LAKE COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | BEAR LAKE MEMORIAL PART B |
| Practice Address |
164 S 5th St Montpelier ID 83254-1557 |
| Practice Telephone | 2088474354 |
| Practice Fax Number | 2088472201 |
| Mailing Telephone | 2088474354 |
| Mailing Fax Number | 2088472201 |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2011-01-19 |
| Authorized Official Name | ROD JACOBSON (CEO) |
| Authorized Official Telephone | 2088471630 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Bear Lake Memorial Part B | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447452800 | Bear Lake County Memorial Hospital | Community/Behavioral Health | 822 Washington St, Montpelier, ID 83254-1423 | 2007-06-05 |
| 1336125533 | Bear Lake County Memorial Hospital | General Acute Care Hospital | 164 S 5th St, Montpelier, ID 83254-1557 | 2005-12-20 |
| 1699057166 | Bear Lake County Memorial Hospital | Family Medicine | 465 Washington St, Montpelier, ID 83254-1544 | 2011-09-12 |
| 1811138910 | Bear Lake County Memorial Hospital | Obstetrics & Gynecology | 465 Washington St, Montpelier, ID 83254-1544 | 2009-03-19 |
| 1174741441 | Bear Lake County Memorial Hospital | Internal Medicine | 166 S 5th St, Montpelier, ID 83254-1557 | 2007-04-23 |
| 1619195989 | Bear Lake County Memorial Hospital | General Acute Care Hospital | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-04-23 |
| 1699814574 | Bear Lake County Memorial Hospital | Pharmacy | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-02-06 |
| 1669521084 | Bear Lake County Memorial Hospital | Home Health | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-01-09 |
| 1740370626 | Bear Lake County Memorial Hospital | Clinic/Center | 164 S 5th St, Montpelier, ID 83254-1557 | 2006-10-13 |
| 1659461531 | Bear Lake County Memorial Hospital | Skilled Nursing Facility | 164 S 5th St, Montpelier, ID 83254-1557 | 2006-10-13 |
| Street Address |
164 S 5TH ST |
| City | MONTPELIER |
| State | ID |
| Zip Code | 83254-1557 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336125533 | Bear Lake County Memorial Hospital | General Acute Care Hospital | 164 S 5th St, Montpelier, ID 83254-1557 | 2005-12-20 |
| 1821482365 | William Crane | Physical Therapist | 164 S 5th St, Montpelier, ID 83254-1557 | 2015-03-23 |
| 1457741167 | Jacob L. Lufkin | Registered Nurse | 164 S 5th St, Montpelier, ID 83254-1597 | 2015-02-02 |
| 1184065849 | Joseph Dayton | Physician Assistant | 164 S 5th St, Montpelier, ID 83254-1557 | 2013-07-10 |
| 1235470196 | Bonnie Colleen Caywood | Dietitian, Registered | 164 S 5th St, Montpelier, ID 83254-1557 | 2013-03-01 |
| 1639399793 | Bear Lake Memorial Hospital | General Acute Care Hospital | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-04-30 |
| 1619195989 | Bear Lake County Memorial Hospital | General Acute Care Hospital | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-04-23 |
| 1386767465 | Richard Bergman | Social Worker | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-04-06 |
| 1699814574 | Bear Lake County Memorial Hospital | Pharmacy | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-02-06 |
| 1669521084 | Bear Lake County Memorial Hospital | Home Health | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366597866 | Joseph F Decker Professional Corp | Surgery | 164 S 5th, Montpelier, ID 83254 | 2007-01-24 |
| 1447311139 | Bear Lake County | Ambulance | 385 Cemetary Road, Montpelier, ID 83254 | 2006-12-13 |
| 1073685343 | Steven D Hammond | Dentist | 455 Washington St, Montpelier, ID 83254 | 2006-11-14 |
| 1982610549 | Dorian S Grunig | Nurse Anesthetist, Certified Registered | 164 South 5th, Montpelier, ID 83254 | 2006-08-01 |
| 1104840412 | Harold A Olson | Pharmacist | 765 Washington St., Montpelier, ID 83254 | 2006-07-27 |
| 1033603345 | Sydnie M Hobbs | Nurse Practitioner | 152 S 4th St, Montpelier, ID 83254 | 2018-06-20 |
| 1265505705 | Robert D Degnan | Obstetrics & Gynecology | 742 Washington St, Montpelier, ID 83254 | 2006-11-15 |
| 1952491714 | Gary Scott Griffin | Nurse Anesthetist, Certified Registered | 164 South 5th, Montpelier, ID 83254 | 2006-10-13 |
| 1013027952 | Matthew Brinton Stevens | Chiropractor | 710 N 4th St, Montpelier, ID 83254-1050 | 2006-08-30 |
| 1265542435 | Reset P.a. | Chiropractor | 710 N 4th St, Montpelier, ID 83254-1050 | 2006-08-30 |
| Find all providers in zip 83254 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831518497 | Russell Davignon | Orthopaedic Surgery | 225 Westwood Dr, Montpelier, VT 05602-8453 | 2014-04-10 |
| 1326073537 | Kerry Glen Jepsen | Orthopaedic Surgery | 164 S 5th St, Montpelier, ID 83254-1557 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770101594 | Brittney Davis | Orthopaedic Surgery | 5910 W Targee St, Boise, ID 83709-3151 | 2020-07-08 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1942668157 | Allied Orthopaedics, LLC | Orthopaedic Surgery | 1789 S Broadway Ave, Suite 100, Boise, ID 83706-3800 | 2016-02-02 |
| 1053779264 | Allied Orthopaedics, LLC | Orthopaedic Surgery | 16818 N Marketplace Blvd, Nampa, ID 83687-5140 | 2016-02-02 |
| 1841611027 | Christopher Frederic Jessen | Orthopaedic Surgery | 5475 E Shoreline Dr, Post Falls, ID 83854-6858 | 2013-12-14 |
| 1881934404 | Kym Orthopedics Pllc | Orthopaedic Surgery | 3316 4th St #4b, Lewiston, ID 83501-4405 | 2013-02-19 |
| 1891056826 | Jonathan Klaucke | Orthopaedic Surgery | 606 N Third Ave Ste 201, Sandpoint, ID 83864 | 2012-06-06 |
| 1508168139 | Lyman Orthopedics Pllc | Orthopaedic Surgery | 1875 N Lakewood Dr, Suite 200, Coeur D Alene, ID 83814-4928 | 2010-12-02 |
| 1639495708 | Krysten Marie Bell | Orthopaedic Surgery | 2178 S Myers Pl, Boise, ID 83706-5503 | 2010-04-14 |
| 1700114725 | David Louis Schenkar | Orthopaedic Surgery | 110 E Gulch Rd, Hailey, ID 83333-8496 | 2009-12-02 |
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| City | MONTPELIER |
| Zip Code | 83254 |
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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.