KOOTENAI HEALTH (NPI# 1205113784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205113784 |
| Entity Type | Organization |
| Organization Name | KOOTENAI HEALTH |
| Other Organization Name | HEART CLINICS OREGON |
| 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 | 2011-11-10 |
| Last Update Date | 2019-03-14 |
| Authorized Official Name | JON D NESS (CEO) |
| Authorized Official Telephone | 2086254000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
42 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | LICENSE | 42 | 01 |
| Other Name | Type Code |
|---|---|
| Heart Clinics Oregon | Other Name - Individual/Organization |
| 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 |
| 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 |
| 1568567360 | Kootenai Health | Psychiatric 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 | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1538455878 | Elizabeth M Rau | Internal Medicine | 700 W Ironwood Dr Ste 320, Coeur D Alene, ID 83814 | 2011-06-24 |
| 1952614885 | Providence Health & Services | Internal Medicine | 700 W Ironwood Dr, 214, Coeur D Alene, ID 83814-2656 | 2010-07-20 |
| 1306163134 | Donald Franklin Engles | Internal Medicine | 700 W Ironwood Dr, Ste 320, Coeur D Alene, ID 83814-2656 | 2010-05-04 |
| 1720130933 | Monica F Donegan | Internal Medicine | 1607 Lincoln Way, Suite 200, Coeur D Alene, ID 83814 | 2007-01-17 |
| 1164504411 | Anita E Robinson | Internal Medicine | 1607 Lincoln Way, Suite 200, Coeur D Alene, ID 83814-2476 | 2006-10-19 |
| 1194831057 | Aaron J Notestine | Internal Medicine | 700 W Ironwood Dr, 320, Coeur D Alene, ID 83814-2656 | 2006-08-22 |
| 1285680488 | Dennis B Cooke | Internal Medicine | 700 W Ironwood Dr, Suite 350, Coeur D Alene, ID 83814-2656 | 2006-05-26 |
| 1831145069 | Carl L Hanson | Internal Medicine | 700 W Ironwood Dr, Suite 350, Coeur D Alene, ID 83814-2656 | 2006-05-26 |
| Find all providers in COEUR D ALENE | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
Please comment or provide details below to improve the information on KOOTENAI HEALTH.
| 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.