MCCALL MEMORIAL HOSPITAL (NPI# 1336200096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336200096 |
| Entity Type | Organization |
| Organization Name | MCCALL MEMORIAL HOSPITAL |
| Other Organization Name | INTEGRATIVE MEDICINE CLINIC |
| Practice Address |
203 Hewitt St Mccall ID 83638-3704 |
| Mailing Address |
1000 State St Mccall ID 83638-3704 |
| Practice Telephone | 2086341400 |
| Mailing Telephone | 2086342221 |
| Mailing Fax Number | 2086347112 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2008-08-27 |
| Authorized Official Name | KAREN J KELLIE (PRESIDENT ADMINISTRATOR) |
| Authorized Official Telephone | 2086342221 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC0050X |
Clinic/Center Specialization: Critical Access Hospital |
11 | ID | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS CLINIC # | 8M924 | 01 |
| Other Name | Type Code |
|---|---|
| Integrative Medicine Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265564967 | Mccall Memorial Hospital | Clinic/Center | 454 West Roseberry Rd, Suite 103, Donnelly, ID 83615 | 2007-03-09 |
| 1265442388 | Mccall Memorial Hospital | Clinic/Center | 1010 State Street, Mccall, ID 83638-3704 | 2006-08-09 |
| 1174533277 | Mccall Memorial Hospital | Clinic/Center | 323 Deinhard Ln Ste A, Mccall, ID 83638-4703 | 2006-08-09 |
| 1669534756 | Mccall Memorial Hospital | Counselor | 1000 State St, Mccall, ID 83638-3704 | 2006-12-14 |
| 1619039732 | Mccall Memorial Hospital | Medicare Defined Swing Bed Unit | 1000 State St, Mccall, ID 83638-3704 | 2006-12-14 |
| 1558422212 | Mccall Memorial Hospital | General Acute Care Hospital | 1000 State St, Mccall, ID 83638-3704 | 2006-12-13 |
| 1790846392 | Mccall Memorial Hospital | Physician Assistant | 1000 State St, Mccall, ID 83638-3704 | 2006-12-13 |
| Street Address |
203 HEWITT ST |
| City | MCCALL |
| State | ID |
| Zip Code | 83638-3704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790935427 | Connie Mcclaran | Registered Nurse | 203 Hewitt St, Mccall, ID 83638 | 2008-09-30 |
| 1598914145 | Wendy Carson | Massage Therapist | 203 Hewitt St, Mccall, ID 83638 | 2008-09-18 |
| 1992954622 | Rachel Arndt | Dietitian, Registered | 203 Hewitt St, Mccall, ID 83638 | 2008-09-18 |
| 1356590822 | Elizabeth Ostermiller | Acupuncturist | 203 Hewitt St, Mccall, ID 83638 | 2008-09-09 |
| 1861640328 | Jodie K Lea | Marriage & Family Therapist | 203 Hewitt St, Mccall, ID 83638 | 2008-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255897708 | Seanne Jo Safaii | Dietitian, Registered | 1100 Heaven's Gate Ct. #1910, Mccall, ID 83638 | 2019-02-20 |
| 1053881284 | Debra Ann Jones Yensen | Counselor | 1242 Herrick Street N, Mccall, ID 83638 | 2018-11-30 |
| 1306369681 | Cheyene Joseph Nickerson | Pharmacist | 132 East Lake Street, Mccall, ID 83638 | 2017-07-19 |
| 1669923892 | Amy Leigh Forkan | Massage Therapist | 301 E Park St., Mccall, ID 83638 | 2016-10-24 |
| 1770982597 | Rachel L Smith | Acupuncturist | 106 E. Park St, Suite 102, Mc Call, ID 83638 | 2014-08-18 |
| 1275944498 | Central Idaho Counseling, Pllc | Social Worker | 125 Commerce St., Suite B, Mccall, ID 83638 | 2014-05-09 |
| 1548690829 | Sze Wan Chan | Pharmacist | 1001 North 2nd Street, Mccall, ID 83638 | 2013-11-22 |
| 1467882274 | Tamara Nagoda | Speech-Language Pathologist | 304 Edgewater Circle, Mccall, ID 83638 | 2013-11-14 |
| 1457537896 | Thomas L Moore | Counselor | 310 E. Lake St., Tom Moore, Mccall, ID 83638 | 2008-01-16 |
| 1659581585 | Barbara Gail Norton | Social Worker | 125 Commerce St, Suite B, Mccall, ID 83638 | 2007-05-22 |
| Find all providers in zip 83638 | ||||
| Taxonomy Code | 261QC0050X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Critical Access Hospital |
| An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265442388 | Mccall Memorial Hospital | Clinic/Center | 1010 State Street, Mccall, ID 83638-3704 | 2006-08-09 |
| 1174533277 | Mccall Memorial Hospital | Clinic/Center | 323 Deinhard Ln Ste A, Mccall, ID 83638-4703 | 2006-08-09 |
| 1235306861 | Mccall Medical Clinics | Clinic/Center | 209 Forest St, Mccall, ID 83638-5256 | 2008-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265564967 | Mccall Memorial Hospital | Clinic/Center | 454 West Roseberry Rd, Suite 103, Donnelly, ID 83615 | 2007-03-09 |
| 1588069678 | Syringa General Hospital District Cif | Clinic/Center | 607 W Main St, Grangeville, ID 83530-1345 | 2014-10-31 |
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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.