KOOTENAI MEDICAL CENTER (NPI# 1629249370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629249370 |
| Entity Type | Organization |
| Organization Name | KOOTENAI MEDICAL CENTER |
| Practice Address |
2003 Lincoln Way Coeur D Alene ID 83814-2611 |
| Practice Telephone | 2086662000 |
| Practice Fax Number | 2086663963 |
| Mailing Telephone | 2086662000 |
| Mailing Fax Number | 2086663963 |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2008-03-20 |
| Authorized Official Name | MS. MELANIE M MICHELS (PATIENT ACCOUNT REPRESENTATIVE) |
| Authorized Official Telephone | 2086662219 |
| Is Organization Subpart | Y |
| Parent Organization Name | KOOTENAI MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
42 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598024978 | Kootenai Medical Center | General Acute Care Hospital | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2012-05-07 |
| 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 |
| 1205030293 | Kootenai Medical Center | General Acute Care Hospital | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2007-06-13 |
| Street Address |
2003 LINCOLN WAY |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-2611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861485161 | Warren C Keene | Emergency Medicine | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2005-08-23 |
| 1124352950 | Sheila Schaal | Dietitian, Registered | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2009-09-26 |
| 1710140157 | Deborah E Schoonover | Nurse Practitioner | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2008-07-07 |
| 1437326980 | Kootenai Medical Center | Internal Medicine | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2008-05-14 |
| 1174707020 | Jenna Marie Sielaff | Physician Assistant | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2007-12-27 |
| 1164619656 | James P Osmanski II Do | Internal Medicine | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2007-09-27 |
| 1750574315 | Tarah L. Boerner | Dietitian, Registered | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2007-08-27 |
| 1558567966 | Julie Michelle Johnson | Pharmacist | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2007-06-22 |
| 1205030293 | Kootenai Medical Center | General Acute Care Hospital | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2007-06-13 |
| 1942402698 | Linda Sue Czirr | Pharmacist | 2003 Lincoln Way, Coeur D Alene, ID 83814-2611 | 2007-06-04 |
| 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 | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487168118 | Kami Bowcut | Physician Assistant | 700 W Ironwood Dr Ste 341, Coeur D Alene, ID 83814-4404 | 2017-11-16 |
| 1144672361 | Alexandra Marie Hyndman | Physician Assistant | 2236 N Merritt Creek Loop Ste A, Coeur D Alene, ID 83814-4960 | 2016-07-12 |
| 1851790901 | Jeff Mitchell | Physician Assistant | 700 W Ironwood Dr, 341, Coeur D Alene, ID 83814-2656 | 2014-08-14 |
| 1326237413 | Jennifer Lyn Wegler | Physician Assistant | 1110 W Park Pl, Ste 202, Coeur D Alene, ID 83814-2781 | 2007-10-15 |
| 1427131721 | Mary H Eggleston Thompson | Physician Assistant | 3320 N Grand Mill Ln, Coeur D Alene, ID 83814-5689 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881218089 | Michael Keegan Huntsman | Physician Assistant | 730 Aspen Ave, Shelley, ID 83274-1400 | 2020-06-03 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1831647197 | Nicholas Hensley | Physician Assistant | 3155 Channing Way Ste B, Idaho Falls, ID 83404-7534 | 2016-09-15 |
| 1811369549 | Anna Stoia | Physician Assistant | 4401 E. Tuscany Ave., Nampa, ID 83686 | 2015-10-21 |
| 1982937066 | Don H Curtis | Physician Assistant | 348 W Bloomington Dr, Meridian, ID 83642-6942 | 2009-09-08 |
| 1801073655 | Tracy D. Mickelsen | Physician Assistant | 3015 E Magic View Dr, Meridian, ID 83642-3743 | 2008-01-23 |
| 1356437172 | Clare Elizabeth York | Physician Assistant | 805 Main St., Salmon, ID 83467 | 2006-10-05 |
| 1891707618 | Brian Keith Lachapelle | Physician Assistant | 6140 W Curtisan, Ste 102, Boise, ID 83704 | 2006-08-12 |
| 1992743215 | Bill Stahlberg | Physician Assistant | 211 Forest St, Mccall, ID 83638-5256 | 2006-06-02 |
| 1780641530 | Alicia R Borst | Physician Assistant | 3960 W. Wainwright, Boise, ID 83713 | 2006-04-26 |
| 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.