NPIMap

Individual provider Active NPI

William Edward Caldwell III

  • Physician Assistant
  • Orofino, ID
National Provider Identifier
1083589014
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2171884 Issued in ID
Practice address
1055 Riverside Ave
Orofino, ID 83544
Phone
(208) 476-5777
NPI assigned
Oct 8, 2025
Last updated
Nov 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2171884 ID Primary

Addresses

Primary practice location

1055 Riverside Ave
Orofino, ID 83544

Mailing address

1055 Riverside Ave
Orofino, ID 83544
Phone (208) 476-5777

Other practice location 1

301 Cedar St
Orofino, ID 83544-9029
Phone (208) 476-5777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251117003843 ID Practitioner - Physician Assistant 5890286900 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2171884IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clearwater Valley Hospital & Clinics Inc. CurrentSince Oct 30, 2025 Accepting new patients
Clearwater Valley Hospital & Clinics Inc. Family Medicine CurrentSince Oct 30, 2025 Accepting new patients
Clearwater Valley Hospital & Clinics Inc. CurrentSince Nov 9, 2025 Accepting new patients
Clearwater Valley Hospital & Clinics Inc. Family Medicine Past Accepting new patients

Locations

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

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1759881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1083589014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 RIVERSIDE AVE",
            "city": "OROFINO",
            "state": "ID",
            "postal_code": "83544",
            "telephone_number": "208-476-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 RIVERSIDE AVE",
            "city": "OROFINO",
            "state": "ID",
            "postal_code": "83544",
            "telephone_number": "208-476-5777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Cedar St",
            "address_purpose": "LOCATION",
            "city": "Orofino",
            "state": "ID",
            "postal_code": "835449029",
            "country_code": "US",
            "telephone_number": "208-476-5777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "WILLIAM",
        "middle_name": "EDWARD",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-08",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "2171884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orofino, ID

Sources for this page

Verify at the official NPI Registry.