KOOTENAI HEALTH (NPI# 1568567360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568567360 |
| Entity Type | Organization |
| Organization Name | KOOTENAI HEALTH |
| Practice Address |
2003 Kootenai Health Way Coeur D Alene ID 83814-6051 |
| Practice Telephone | 2086254000 |
| Practice Fax Number | 2086255731 |
| Mailing Telephone | 2086254000 |
| Mailing Fax Number | 2086255731 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2015-09-25 |
| Authorized Official Name | JON D NESS (CEO) |
| Authorized Official Telephone | 2086254000 |
| Is Organization Subpart | Y |
| Parent Organization Name | KOOTENAI HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 42 | ID | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | REGENCE BLUE SHIELD | 000010004925 | 01 |
| ID | BLUE CROSS | 01008 | 01 |
| ID | 805183600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194345199 | Kootenai Health | Durable Medical Equipment & Medical Supplies | 700 W Ironwood Dr Ste 159, Coeur D Alene, ID 83814-4401 | 2020-04-20 |
| 1205113784 | Kootenai Health | Internal Medicine | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2011-11-10 |
| 1699807743 | Kootenai Health | Internal Medicine | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2007-03-12 |
| 1700918851 | Kootenai Health | Radiology | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2007-03-12 |
| 1174661151 | Kootenai Health | General Acute Care Hospital | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2007-02-02 |
| 1609925023 | Kootenai Health | Durable Medical Equipment & Medical Supplies | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2007-01-09 |
| 1235288655 | Kootenai Health | Neurological Surgery | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2007-01-09 |
| 1316096738 | Kootenai Health | Counselor | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2007-01-09 |
| 1659476455 | Kootenai Health | Rehabilitation Unit | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2006-09-14 |
| 1992798409 | Kootenai Health | General Acute Care Hospital | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2005-08-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | KOOTENAI HEALTH | 2003 Kootenai Health Wy, Coeur D Alene, ID 83814-6051 |
| Street Address |
2003 KOOTENAI HEALTH WAY |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-6051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912909151 | Pamela S Pomeroy | Nurse Practitioner | 2003 Kootenai Health Way, Coeur D Alene, ID 83814 | 2005-06-01 |
| 1104425149 | Denise White | Nurse Practitioner | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2020-10-21 |
| 1992343487 | Audrey Nordness | Pharmacist | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2019-12-15 |
| 1881245017 | Jackie Rae Fitting | Pharmacist | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2019-09-29 |
| 1336790567 | Shane Oliver Withers Jr. | Pharmacist | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2019-09-29 |
| 1447800552 | Keith Mccullough | Physician Assistant | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2019-09-19 |
| 1568012102 | Kaitlin Wendt | Nurse Practitioner | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2019-09-16 |
| 1215586862 | Heather A Hamilton | Social Worker | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2019-09-06 |
| 1205498193 | Guy Hoenke | Registered Nurse | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2019-07-01 |
| 1407417843 | Maddison M Ray | Dietitian, Registered | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2019-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
| 1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| Find all providers in zip 83814 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164469870 | St Lukes Magic Valley Regional Medical Center Ltd | Psychiatric Unit | 228 Shoup Ave W, Twin Falls, ID 83301-5022 | 2006-06-01 |
| 1740287911 | Eastern Idaho Health Services Inc | Psychiatric Unit | 2280 E 25th St, Idaho Falls, ID 83404-7542 | 2005-07-04 |
| 1841719713 | Bmh Inc | Psychiatric Unit | 98 Poplar St, Blackfoot, ID 83221 | 2017-09-12 |
| 1417330119 | St. Luke's Canyon View | Psychiatric Unit | 228 Shoup Ave W, Twin Falls, ID 83301-5022 | 2015-06-30 |
| 1205975851 | St. Joseph Hospital, LLC | Psychiatric Unit | 415 6th St, Lewiston, ID 83501-2431 | 2007-02-06 |
| 1770687857 | St. Alphonsus Reg Med | Psychiatric Unit | 1055 N Curtis Rd, Boise, ID 83706 | 2006-09-11 |
| 1295777274 | Portneuf Medical Center Behavioral Health Servi | Psychiatric Unit | 777 Hospital Way, Pocatello, ID 83201-5175 | 2006-06-12 |
| 1891732905 | West Valley Medical Center, Inc. | Psychiatric Unit | 1717 Arlington Ave, Caldwell, ID 83605-4802 | 2006-05-31 |
| City | COEUR D ALENE |
| Zip Code | 83814 |
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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.