KOOTENAI MEDICAL CENTER (NPI# 1598024978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598024978 |
| Entity Type | Organization |
| Organization Name | KOOTENAI MEDICAL CENTER |
| Other Organization Name | KOOTENAI OUTPATIENT IMAGING |
| 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 | 2012-05-07 |
| Last Update Date | 2012-05-07 |
| Authorized Official Name | JON D NESS (CEO) |
| Authorized Official Telephone | 2086662000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 42 | ID | Hospitals |
| Other Name | Type Code |
|---|---|
| Kootenai Outpatient Imaging | Doing Business As Name - Organization |
| 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 |
| 1780981902 | Kootenai Medical Center | Clinic/Center | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2011-02-24 |
| 1437326980 | Kootenai Medical Center | Internal Medicine | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2008-05-14 |
| 1629249370 | Kootenai Medical Center | Physician Assistant | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2008-03-20 |
| 1205030293 | Kootenai Medical Center | General Acute Care Hospital | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2007-06-13 |
| 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 | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205030293 | Kootenai Medical Center | General Acute Care Hospital | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2007-06-13 |
| 1174661151 | Kootenai Health | General Acute Care Hospital | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2007-02-02 |
| 1992798409 | Kootenai Health | General Acute Care Hospital | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2005-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1225379183 | Sterling Hospital LLC | General Acute Care Hospital | 5412 S. Rock House Cir, Idaho Falls, ID 83406 | 2013-03-01 |
| 1023367828 | Stanley J Waters | General Acute Care Hospital | 1795 S Sub Station Rd, Emmett, ID 83617-9431 | 2012-09-07 |
| 1194908053 | Boise Intensive Care Hospital, Inc. | General Acute Care Hospital | 2131 South Bonito Way, Meridian, ID 83642-1659 | 2007-12-13 |
| 1346454337 | West Valley Medical Center | General Acute Care Hospital | 3720 S Indiana Ave, Caldwell, ID 83605 | 2007-05-09 |
| 1730203845 | Eastern Idaho Regional Medical Center | General Acute Care Hospital | 10701 S 1st E, Idaho Falls, ID 83404-7770 | 2007-03-16 |
| 1942308986 | Idaho Falls Recovery Center | General Acute Care Hospital | 1957 E 17th Street, Idaho Falls, ID 83404 | 2006-09-21 |
| 1609818483 | West Valley Medical Center Inc | General Acute Care Hospital | 381 B South Middleton Road, Middleton, ID 83644 | 2006-06-13 |
| 1992747570 | Madison Co Memorial Hospital | General Acute Care Hospital | 450 E. Main, Rexburg, ID 83440 | 2006-06-11 |
| 1144287756 | Bonner General Hospital, Inc. | General Acute Care Hospital | 520 N 3rd Ave, Sandpoint, ID 83864-1507 | 2006-04-27 |
| Find all providers with the same taxonomy | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
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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.