CARIBOU MEMORIAL HOSPITAL (NPI# 1154524403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154524403 |
| Entity Type | Organization |
| Organization Name | CARIBOU MEMORIAL HOSPITAL |
| Other Organization Name | LAKEVIEW MEDICAL CLINIC |
| Practice Address |
300 S 3rd W Soda Springs ID 83276-1559 |
| Practice Telephone | 2085473341 |
| Practice Fax Number | 2085472790 |
| Mailing Telephone | 2085473341 |
| Mailing Fax Number | 2085472790 |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2012-12-21 |
| Authorized Official Name | JOHN L HOOPES (CEO) |
| Authorized Official Telephone | 2085473341 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
37 | ID | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 806721500 | 05 | |
| ID | BLUE CROSS | 8F975 | 01 |
| Other Name | Type Code |
|---|---|
| LAKEVIEW 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 |
| 1285970582 | Caribou Memorial Hospital | Clinic/Center | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2012-12-14 |
| 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 |
| 1285970582 | Caribou Memorial Hospital | Clinic/Center | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2012-12-14 |
| 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 |
| 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 | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 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 | ||||
| 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.