Snake River Community Clinic

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

Legal business name

SNAKE RIVER COMMUNITY CLINIC

Practice address

215 10TH St
Lewiston, ID 83501-1910

Phone

(208) 743-5899

Fax

(208) 743-9130

NPI assigned

Feb 27, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charlotte Ash

Title

Executive Director

Phone

(208) 743-5899

Specialties & licenses 1

Addresses

Electronic endpoints 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12569/brand/1/csg/1/fhir/r4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582761600000",
    "number": "1003440082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835010006",
            "telephone_number": "208-743-5899",
            "fax_number": "208-743-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 10TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011910",
            "telephone_number": "208-743-5899",
            "fax_number": "208-743-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNAKE RIVER COMMUNITY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A",
        "authorized_official_last_name": "ASH",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "208-743-5899"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "srccfree@protonmail.com",
            "affiliation": "N",
            "endpointDescription": "HIPAA encrypted email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "215 10th St",
            "city": "Lewiston",
            "state": "ID",
            "country_code": "US",
            "postal_code": "835011910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marion Elizabeth Smith, ARNP
• Phillip Smith
• Sadie Ann Smith, LMT
• Saydee Marie Smith
• Theresa M Smith, FNP
• Snake River Community Clinic
• Snake River Rehabilitation Counseling Services LLC
• Snake River Rehabilitation Counseling Services LLC
• Snake River Rehabilitation Counseling Services LLC
• Snake River Rehabilitation Counseling Services LLC

• General Practice Registered Nurse in Lewiston, ID
• Providers in Lewiston, ID by specialty
• General Practice Registered Nurse in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.