PROVIDENCE HEALTH & SERVICES - BOUNDARY COMMUNITY HOSPITAL (NPI# 1316250244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316250244 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - BOUNDARY COMMUNITY HOSPITAL |
| Other Organization Name | PROVIDENCE SPOKANE HEART INSTITUTE |
| Practice Address |
6640 Kaniksu St Out Patient Dept. Lower Level Bonners Ferry ID 83805-7532 |
| Mailing Address |
Po Box 3776 Seattle WA 98124-3776 |
| Practice Telephone | 5098387711 |
| Mailing Telephone | 4255253030 |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2010-11-12 |
| Authorized Official Name | RANDEE M REID (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 4255256694 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Spokane Heart Institute | Doing Business As Name - Organization |
| Street Address |
6640 KANIKSU ST OUT PATIENT DEPT. LOWER LEVEL |
| City | BONNERS FERRY |
| State | ID |
| Zip Code | 83805-7532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801896683 | Boundary Community Hospital | General Acute Care Hospital | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2005-07-22 |
| 1912367251 | Jeffrey Petersen | Physical Therapist | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2016-02-29 |
| 1124432943 | Mark Pruitt | Emergency Medicine | 6640 Kaniksu St, Bonners Ferry, ID 83805 | 2014-06-19 |
| 1942566195 | Edward Gregory Moellmer | Family Medicine | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2012-04-02 |
| 1861609588 | Edna Faye Eby | Dietitian, Registered | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2007-05-16 |
| 1215082565 | Boundary Community Hospital | Pharmacy | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2007-01-25 |
| 1568517811 | Boundary Community Hospital Pharmacy | Pharmacy | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2007-01-25 |
| 1679621098 | Boundary Community Hospital | Family Medicine | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2007-01-08 |
| 1679649396 | Stuart Kendall Willis IIi | Emergency Medicine | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2006-11-27 |
| 1316022247 | Boundary Community Hospital | Medicare Defined Swing Bed Unit | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2006-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366990996 | Nicole Diana Madill | Counselor | 687 Cody Street, Bonners Ferry, ID 83805 | 2016-09-12 |
| 1154770295 | Rachel Meiland Webster | Social Worker | 6686 Augusta Bldg 100, Bonners Ferry, ID 83805 | 2016-06-09 |
| 1205211786 | Robert Rossi | Social Worker | Kaniksu Health Services, 6615 Comanche St, Bonners Ferry, ID 83805 | 2015-07-24 |
| 1154660041 | Mark R. Barker, O.d.p.c. | Optometrist | 7177 Main St., Bonners Ferry, ID 83805 | 2013-02-12 |
| 1003182668 | Jessica Faye Horricks | Dentist | 6615 Commanche, Bonners Ferry, ID 83805 | 2012-03-28 |
| 1427334929 | Tanya Marie Allmaras | Physician Assistant | 6635 Comanche Street, Bonners Ferry, ID 83805 | 2011-10-27 |
| 1114259769 | Joshua Olen Shelton | Chiropractor | 6389 Bonner St., Bonners Ferry, ID 83805 | 2010-02-08 |
| 1558690644 | April C Christman | Social Worker | 6615 Comanche Street, Bonners Ferry, ID 83805 | 2009-12-18 |
| 1407006067 | Denys Taipale-knight | Counselor | 385 Moose Ridge Lane, Bonners Ferry, ID 83805 | 2008-09-19 |
| 1013126457 | John Pierce Brownlee Jr. | Registered Nurse | 6640 Kaniksu Street, Boundary Community Hospital, Bonners Ferry, ID 83805 | 2007-05-22 |
| Find all providers in zip 83805 | ||||
| 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 |
|---|---|---|---|---|
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1801336276 | Bmh, Inc. | Internal Medicine | 235 Poplar St, Blackfoot, ID 83221 | 2017-03-03 |
| 1811201312 | Providence Health & Services | Internal Medicine | 715 S Washington, Suite A, Moscow, ID 83843-0000 | 2010-07-27 |
| 1730323080 | Wayne Wright | Internal Medicine | 2664 E 3700 N, Twin Falls, ID 83301-0145 | 2009-04-29 |
| 1184824617 | Michael D Kenner, Md,pc | Internal Medicine | 1721 S 10th Ave, Caldwell, ID 83605-4839 | 2007-07-23 |
| 1497807812 | Grande Ronde Hospital, Inc | Internal Medicine | 300 E Jefferson St Ste 101, Boise, ID 83712-6221 | 2007-01-17 |
| 1700983137 | Lee Walter Gould | Internal Medicine | 307 St. John's Way, Suite 114, Lewiston, ID 83501-2456 | 2006-09-20 |
| 1730285719 | Beth R Malasky | Internal Medicine | 6140 Curtisian, Ste 200, Boise, ID 83704-0107 | 2006-09-16 |
| 1730192329 | Cardiovascular Consultants of Idaho | Internal Medicine | 1070 N Curtis Rd, Ste 125, Boise, ID 83706-1238 | 2006-08-14 |
| 1477578300 | John E Lassetter | Internal Medicine | 2001 S Woodruff Ave Ste 3, Idaho Falls, ID 83404 | 2006-07-13 |
| Find all providers with the same taxonomy | ||||
| City | BONNERS FERRY |
| Zip Code | 83805 |
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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.