BOUNDARY COMMUNITY HOSPITAL (NPI# 1801896683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801896683 |
| Entity Type | Organization |
| Organization Name | BOUNDARY COMMUNITY HOSPITAL |
| Practice Address |
6640 Kaniksu St Bonners Ferry ID 83805-7532 |
| Practice Telephone | 2082673141 |
| Practice Fax Number | 2082670660 |
| Mailing Telephone | 2082673141 |
| Mailing Fax Number | 2082670660 |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2019-10-01 |
| Authorized Official Name | PRESTON J BECKER (CEO) |
| Authorized Official Telephone | 2082674850 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
43 | ID | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 002810200 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801273552 | Boundary Community Hospital | Clinic/Center | 6641 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2015-05-01 |
| 1215082565 | Boundary Community Hospital | 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 |
| 1316022247 | Boundary Community Hospital | Medicare Defined Swing Bed Unit | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2006-10-26 |
| 1225113152 | Boundary Community Hospital | Skilled Nursing Facility | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2006-10-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BOUNDARY COMMUNITY HOSPITAL NURSING HOME | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 |
| Street Address |
6640 KANIKSU ST |
| City | BONNERS FERRY |
| State | ID |
| Zip Code | 83805-7532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1316250244 | Providence Health & Services - Boundary Community Hospital | Internal Medicine | 6640 Kaniksu St, Out Patient Dept. Lower Level, Bonners Ferry, ID 83805-7532 | 2010-07-20 |
| 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 | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851761464 | Brent Leavitt | General Acute Care Hospital | 4928 Pleasant View Dr, Chubbuck, ID 83202-1640 | 2015-09-25 |
| 1053669598 | Teton Valley Health Care, Inc | General Acute Care Hospital | 120 E Howard Avenue, Driggs, ID 83422-5112 | 2012-08-15 |
| 1639406267 | Florence Hospital, LLC | General Acute Care Hospital | 1300 E State St, Suite 102, Eagle, ID 83616-7059 | 2009-11-03 |
| 1912132176 | Initiatives Healthcare, LLC | General Acute Care Hospital | 1205 N 11th St, Boise, ID 83702-4102 | 2009-05-18 |
| 1417122821 | Elmore Medical Center Specialty Physician Group | General Acute Care Hospital | 890 N 6th E, Mountain Home, ID 83647-2206 | 2008-04-25 |
| 1275703241 | North Canyon Medical Center, Inc. | General Acute Care Hospital | 267 North Canyon Drive, Gooding, ID 83330-1858 | 2008-03-06 |
| 1720298102 | Weiser Valley Hospital District | General Acute Care Hospital | 645 E. 5th Street, Weiser, ID 83672-2202 | 2007-05-23 |
| 1548320435 | Benewah Community Hospital | General Acute Care Hospital | 229 South 7th St, St Maries, ID 83861 | 2006-12-11 |
| 1295769537 | Gooding County Hospital District | General Acute Care Hospital | 1120 Montana St, Gooding, ID 83330-1858 | 2006-07-11 |
| 1881641629 | Weiser Valley Hospital District | General Acute Care Hospital | 645 E. 5th St., Weiser, ID 83672-2202 | 2006-05-27 |
| 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.