NPIMap

Organization Active NPI

Clearwater Valley Hospital & Clinics Inc.

Doing business as Clearwater Valley Health

  • Family Medicine Physician
  • Orofino, ID
National Provider Identifier
1073551396
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLEARWATER VALLEY HOSPITAL & CLINICS INC.
Doing business as
Clearwater Valley Health
Clearwater Valley Hospital Clinic
Practice address
301 Cedar St
Orofino, ID 83544-9029
Phone
(208) 476-4555
Fax
(208) 476-5385
NPI assigned
Jun 2, 2006
Last updated
Aug 10, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
KOOTENAI HEALTH, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

Name
Lenne J Bonner
Title
Ceo
Phone
(208) 476-8008

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Physician Assistant 363A00000X NU

Addresses

Primary practice location

301 Cedar St
Orofino, ID 83544-9029

Mailing address

301 Cedar St
Orofino, ID 83544-9029
Phone (208) 476-4555

Other identifiers 1

IdentifierTypeStateIssuer
805060900MedicaidID

Other names 2

  • Clearwater Valley Health Doing business as
  • Clearwater Valley Hospital Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031117000264 ID Part B Supplier - Clinic/Group Practice 0547173346 Receives reassigned benefits from 92 practitioners
1 other NPI on this enrollment
Practice locations: Orofino, ID
O20061104000428 ID Part A Provider - Critical Access Hospital 0547173346 Receives reassigned benefits from 81 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Orofino, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073551396. Details of each certification follow.

Hospital certification: CCN 131320

Legal name
CLEARWATER VALLEY HOSPITAL & CLINICS
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Feb 1, 2003
Last certification
Dec 11, 2020
Beds
23
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
301 Cedar St
Orofino, ID 83544-9029

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Clearwater Valley Hospital & ClinicsCCN 131320 · All quality measures
Overall star rating
2 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Clearwater Valley Hospital

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Cynthia O'Brien Individual Corporate DirectorBoard Member Apr 1, 2020
Lenne J Bonner Individual Corporate OfficerCeo Oct 29, 2007
W-2 Managing EmployeeCeo Oct 29, 2007
Rene Forsman Individual Corporate DirectorBoard Member Apr 1, 2020
Jon Ness Individual OtherCeo Apr 1, 2020
Leonard Hill Individual Corporate DirectorBoard Member Apr 1, 2020
Matt Sartini Individual Corporate DirectorBoard Member Apr 1, 2020
Barbara Jean Glodowski Individual Corporate DirectorBoard Member Apr 1, 2020
Lisa Maurer Individual Corporate DirectorBoard Member Apr 1, 2020
Christina Ulmer Individual Corporate DirectorBoard Member Apr 1, 2020
Clarence J Brunson Individual Corporate DirectorBoard Member Apr 1, 2020
Kootenai Health, Inc. Organization, Coeur D Alene, ID 5% Or Greater Direct Ownership Interest Apr 1, 2020 100%
Jeremy Evans Individual Corporate DirectorBoard Member Apr 1, 2020
Kimberly Ingram Individual Corporate DirectorBoard Member Apr 1, 2020
Kelly J McGrath Individual Corporate DirectorBoard Member Apr 1, 2020

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 102

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 102

Affiliated clinicians 111

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 111

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1073551396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CEDAR ST",
            "city": "OROFINO",
            "state": "ID",
            "postal_code": "835449029",
            "telephone_number": "208-476-4555",
            "fax_number": "208-476-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 CEDAR ST",
            "city": "OROFINO",
            "state": "ID",
            "postal_code": "835449029",
            "telephone_number": "208-476-4555",
            "fax_number": "208-476-5385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER VALLEY HOSPITAL & CLINICS INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOOTENAI HEALTH, INC.",
        "enumeration_date": "2006-06-02",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "BONNER",
        "authorized_official_first_name": "LENNE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-476-8008"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805060900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clearwater Valley Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clearwater Valley Hospital Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clearwater Valley Hospital Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orofino, ID

Sources for this page

Verify at the official NPI Registry.