St Benedicts Family Medical Center

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

ST BENEDICTS FAMILY MEDICAL CENTER

Practice address

280 W Main St
Wendell, ID 83355-5201

Phone

(208) 563-6663

Fax

(208) 536-5182

NPI assigned

Jun 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Curtis Maier

Title

Coo

Phone

(208) 324-1122

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• ST BENEDICTS FAMILY CLINIC-WENDELL Other name

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1073559993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 W MAIN ST",
            "city": "WENDELL",
            "state": "ID",
            "postal_code": "833555201",
            "telephone_number": "208-563-6663",
            "fax_number": "208-536-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 W MAIN ST",
            "city": "WENDELL",
            "state": "ID",
            "postal_code": "833555201",
            "telephone_number": "208-563-6663",
            "fax_number": "208-536-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST BENEDICTS FAMILY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MAIER",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "208-324-1122",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010142896",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "8G882",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST BENEDICTS FAMILY CLINIC-WENDELL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Rural Health Clinic/Center in Wendell, ID
• Providers in Wendell, ID by specialty
• Rural Health Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.