KOOTENAI MEDICAL CENTER (NPI# 1780981902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780981902 |
Entity Type | Organization |
Organization Name | KOOTENAI MEDICAL CENTER |
Other Organization Name | ADULT DAY PROGRAM |
Practice Address |
2003 Kootenai Health Way Coeur D Alene ID 83814-6051 |
Practice Telephone | 2086662000 |
Practice Fax Number | 2086663963 |
Mailing Telephone | 2086662000 |
Mailing Fax Number | 2086663963 |
Enumeration Date | 2011-02-24 |
Last Update Date | 2011-02-24 |
Authorized Official Name | JON D NESS (CEO) |
Authorized Official Telephone | 2086662000 |
Authorized Official Credential | CEO |
Is Organization Subpart | Y |
Parent Organization Name | KOOTENAI MEDICAL CENTER |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
42 | ID | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ID | M8056472 | 05 |
Other Name | Type Code |
---|---|
Adult Day Program | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598024978 | Kootenai Medical Center | General Acute Care Hospital | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2012-05-07 |
1578840054 | Kootenai Medical Center | Internal Medicine | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2011-11-10 |
1922385400 | Kootenai Medical Center | Internal Medicine | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2011-11-10 |
1437326980 | Kootenai Medical Center | Internal Medicine | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2008-05-14 |
1629249370 | Kootenai Medical Center | Physician Assistant | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2008-03-20 |
1205030293 | Kootenai Medical Center | General Acute Care Hospital | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2007-06-13 |
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 | 261QA0600X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Adult Day Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255977914 | Center Counseling, LLC | Clinic/Center | 140 Evans Ln, Chubbuck, ID 83202-1914 | 2019-11-18 |
1184866105 | Sarah Care of Boise | Clinic/Center | 1655 Vinnell St, Boise, ID 83709-5138 | 2009-04-06 |
1881735041 | Solaridy LLC | Clinic/Center | 312 E Franklin Rd, Meridian, ID 83642-2911 | 2007-02-09 |
1720128341 | Savu Florentina | Clinic/Center | 1900 Cleveland St, Boise, ID 83705-3211 | 2007-02-06 |
1366844409 | Alzheimer Dementia Center | Clinic/Center | 6121 Cleveland Blvd, Caldwell, ID 83607-5129 | 2014-09-19 |
1023433927 | Circles of Caring Adult Day Health Foundation, Inc. | Clinic/Center | 225 E Palouse River Dr, Moscow, ID 83843-8915 | 2014-02-28 |
1083755896 | Serenity Life | Clinic/Center | 312 E Franklin Rd, Meridian, ID 83642-2911 | 2007-02-12 |
City | COEUR D ALENE |
Zip Code | 83814 |
Please comment or provide details below to improve the information on KOOTENAI MEDICAL CENTER.
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.