ST BENEDICTS FAMILY MEDICAL CENTER (NPI# 1073559993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073559993 |
| Entity Type | Organization |
| Organization Name | ST BENEDICTS FAMILY MEDICAL CENTER |
| Other Organization Name | ST BENEDICTS FAMILY CLINIC-WENDELL |
| Practice Address |
280 W Main St Wendell ID 83355-5201 |
| Practice Telephone | 2085636663 |
| Practice Fax Number | 2085365182 |
| Mailing Telephone | 2085636663 |
| Mailing Fax Number | 2085365182 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MR. CURTIS MAIER (COO) |
| Authorized Official Telephone | 2083241122 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
ID | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | REGENCE BLUE SHIELD OF ID | 000010142896 | 01 |
| ID | BLUE CROSS OF IDAHO | 8G882 | 01 |
| Other Name | Type Code |
|---|---|
| ST BENEDICTS FAMILY CLINIC-WENDELL | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992898605 | St Benedicts Family Medical Center | Home Health | 414 N Lincoln, Suite 1, Jerome, ID 83338 | 2006-10-02 |
| 1922037530 | St Benedicts Family Medical Center | Clinic/Center | 115 5th Ave W, Jerome, ID 83338-1824 | 2006-07-03 |
| 1902856727 | St Benedicts Family Medical Center | Skilled Nursing Facility | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2006-05-11 |
| Street Address |
280 W MAIN ST |
| City | WENDELL |
| State | ID |
| Zip Code | 83355-5201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598005233 | Right Choice Urgent Care and Family Medicine | Physician Assistant | 280 W Main St, Wendell, ID 83355-5201 | 2013-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508420373 | K2red LLC | Pharmacy | 447 N Idaho St, Wendell, ID 83355 | 2019-04-27 |
| 1275641540 | Jack C Kulm | Dentist | 410 N Idaho St, Wendell, ID 83355 | 2006-08-28 |
| 1932364387 | Jack C. Kulm Dmd Pa | Dentist | 410 N Idaho St, Wendell, ID 83355 | 2008-07-25 |
| 1710032560 | Independent School District #232 | Local Education Agency (LEA) | 150 E Main St, Wendell, ID 83355 | 2007-01-24 |
| 1184751935 | Preferred Community Homes | Intermediate Care Facility, Mentally Retarded | 2028 E 2975 S, Wendell, ID 83355-3119 | 2007-02-28 |
| 1700945565 | Karen Bunn | Homemaker | 2012 E 2874 S, Wendell, ID 83355-3156 | 2006-12-07 |
| 1467909317 | Tyler Egbert | Student in an Organized Health Care Education/Training Program | 3121 Eagle Ridge Dr, Wendell, ID 83355-3340 | 2016-09-08 |
| 1639572456 | Todays Dental Care Wendell LLC | Dentist | 410 N Idaho St, Wendell, ID 83355-5038 | 2014-10-07 |
| 1649535493 | Jeremiah Mckell Funk | Dentist | 410 N Idaho St, Wendell, ID 83355-5038 | 2012-07-09 |
| 1801923651 | Preferred Community Homes, LLC. | Intermediate Care Facility, Mentally Retarded | 615 2nd Ave W, Wendell, ID 83355-5089 | 2007-02-28 |
| Find all providers in zip 83355 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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|---|---|---|---|---|
| 1376160457 | North Canyon Jerome Clinic | Clinic/Center | 491 Heritage Dr, Jerome, ID 83338-6701 | 2020-07-06 |
| 1063970143 | Idaho Street Medical Clinic | Clinic/Center | 126 Idaho Ave., Homedale, ID 83628-8362 | 2019-03-07 |
| 1568950566 | North Canyon Medical Center, Inc. | Clinic/Center | 718 Hwy 30, Buhl, ID 83316 | 2018-04-25 |
| 1518377019 | North Canyon Medical Center, Inc. | Clinic/Center | 267 N. Canyon Drive, Gooding, ID 83330 | 2014-05-06 |
| 1700206588 | Mvh Bmc LLC | Clinic/Center | 210 S Emerson Ave, Shelley, ID 83274-1229 | 2014-04-21 |
| 1922243088 | Bmh Inc | Clinic/Center | 1355 Parkway Dr, Blackfoot, ID 83221-1656 | 2008-12-03 |
| 1023271731 | Upper Valley Family Medicine Rhc | Clinic/Center | 530 Rigby Lake Dr, Rigby, ID 83442-1271 | 2008-07-03 |
| 1891984167 | Bmh Inc | Clinic/Center | 1425 Parkway Drive, Blackfoot, ID 83221-1758 | 2007-10-23 |
| 1043387426 | Minidoka Memorial Hospital | Clinic/Center | 1308 8th St, Suite 1, Rupert, ID 83350-1530 | 2006-11-29 |
| 1356438816 | Gritman Medical Center Inc | Clinic/Center | 156 6th St, Potlatch, ID 83855 | 2006-10-06 |
| Find all providers with the same taxonomy | ||||
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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.