DIRNE HEALTH CENTERS, INC (NPI# 1689039448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689039448 |
| Entity Type | Organization |
| Organization Name | DIRNE HEALTH CENTERS, INC |
| Other Organization Name | HERITAGE HEALTH |
| Practice Address |
14775 N Kimo Ct Suite B Rathdrum ID 83858-8762 |
| Mailing Address |
Po Box 1387 Hayden ID 83835-1387 |
| Practice Telephone | 2086875627 |
| Mailing Telephone | 2086205200 |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2019-02-27 |
| Authorized Official Name | MICHAEL BAKER (CEO) |
| Authorized Official Telephone | 2082920292 |
| Is Organization Subpart | Y |
| Parent Organization Name | DIRNE HEALTH CENTERS INC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | MEDICARE PART B PTAN | 1378465 | 01 |
| Other Name | Type Code |
|---|---|
| Heritage Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447305610 | Dirne Health Centers, Inc | Dentist | 1090 West Park Place, Suite B, Coeur D Alene, ID 83814 | 2007-01-25 |
| 1235503426 | Dirne Health Centers, Inc | Counselor | 2205 Ironwood Pl, Coeur D Alene, ID 83814-2487 | 2015-11-25 |
| 1689068413 | Dirne Health Centers, Inc | Family Medicine | 109 E Harrison Ave, Coeur D Alene, ID 83814-3238 | 2015-03-18 |
| 1487076048 | Dirne Health Centers, Inc | Counselor | 740 Mckinley Ave, Kellogg, ID 83837-2693 | 2014-01-15 |
| Street Address |
14775 N KIMO CT SUITE B |
| City | RATHDRUM |
| State | ID |
| Zip Code | 83858-8762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396766473 | Christine Danser | Physical Therapist | 14775 N Kimo Ct, Ste A, Rathdrum, ID 83858-8762 | 2006-07-22 |
| 1770957938 | Sonja Enger | Social Worker | 14775 N Kimo Ct, Suite B, Rathdrum, ID 83858-8762 | 2015-11-25 |
| 1669572780 | Rathdrum Clinic, Inc. | Family Medicine | 14775 N Kimo Ct, Suite B, Rathdrum, ID 83858-8762 | 2006-09-25 |
| 1225059157 | Rathdrum Physical Therapy, Inc. | Physical Therapist | 14775 N Kimo Ct, Ste A, Rathdrum, ID 83858-8762 | 2006-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174183578 | Kerri Ruddell | Nurse Practitioner | 16760 Id-41, Rathdrum, ID 83858 | 2019-06-18 |
| 1811555758 | Daniel Whitesitt | Dentist | 14596 Id-41, Rathdrum, ID 83858 | 2019-06-05 |
| 1831437839 | Patricia M Salois | Speech-Language Pathologist | 1564 Washington Street, Rathdrum, ID 83858 | 2013-01-25 |
| 1063554673 | Lakeland Joint School Disrict #272 | Local Education Agency (LEA) | 1564 Washington Ave, Rathdrum, ID 83858 | 2007-02-12 |
| 1275695140 | James M Mcnamara | Dentist | 13997 W Hwy 53, Rathdrum, ID 83858 | 2006-12-15 |
| 1568573962 | Chad Stephen Devore | Dentist | 14596 Hwy 41, Suite A, Rathdrum, ID 83858 | 2006-08-31 |
| 1811982994 | Frances L. White | Contractor | 14528 N Wight St, Rathdrum, ID 83858 | 2005-09-15 |
| 1578061883 | Ann N Moffett | Nurse Practitioner | 858 Commerce Dr., Smelterville, ID 83858 | 2018-02-01 |
| 1063055069 | Karin Sue Duncan | Naturopath | 16726 N Meadowview Ln, Rathdrum, ID 83858-0017 | 2019-10-22 |
| 1770768624 | Gabrielle Durbin | Private Vehicle | W 7164 Diagonal, Rathdrum, ID 83858-0283 | 2008-01-09 |
| Find all providers in zip 83858 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1225517055 | Community Health Clinics, Inc. | Clinic/Center | 4085 E Greenhurst Rd, Nampa, ID 83686-8657 | 2018-08-13 |
| 1982183687 | Community Health Clinics, Inc. | Clinic/Center | 301 S Happy Valley Rd, Nampa, ID 83687-8828 | 2018-08-13 |
| 1396249546 | Community Health Clinic Inc. | Clinic/Center | 521 Carrie Rex, Melba, ID 83641 | 2018-03-22 |
| 1912401381 | Community Health Clinic Inc. | Clinic/Center | 700 N Star Rd, Star, ID 83669-5417 | 2018-03-21 |
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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.