NPIMap

Organization Active NPI

Emp Idaho Nampa, LLC

Doing business as Saint Alphonsus Neighborhood Hospital - South Nampa

  • General Acute Care Hospital
  • Nampa, ID
National Provider Identifier
1093245953
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
71 Issued in ID
Legal business name
EMP IDAHO NAMPA, LLC
Doing business as
Saint Alphonsus Neighborhood Hospital - South Nampa
Practice address
1510 12TH Avenue Rd
Suite 100
Nampa, ID 83686
Phone
(713) 637-1146
Fax
(281) 298-5311
NPI assigned
Jun 14, 2017
Last updated
Jul 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
John Buck, MDNPI 1053383604
Title
Secretary
Phone
(713) 637-1004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 71 ID Primary

Addresses

Primary practice location

1510 12TH Avenue Rd
Suite 100
Nampa, ID 83686

Mailing address

8686 New Trails Dr Ste 100
The Woodlands, TX 77381-1176
Phone (713) 637-1146

Other identifiers 2

IdentifierTypeStateIssuer
13-0072OtherIDMEDICARE
1093245953MedicaidID

Other names 1

  • Saint Alphonsus Neighborhood Hospital - South Nampa Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093245953. Details of each certification follow.

Hospital certification: CCN 130072

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SAINT ALPHONSUS NEIGHBORHOOD HOSPITAL- SOUTH NAMPA
Certification status
Terminated Voluntary: other reason for withdrawal, Dec 22, 2018
Provider type (POS)
Hospital – Short-term
Participating since
Jan 25, 2018
Last certification
Dec 22, 2018
Beds
8
Ownership / control type
Private (for profit)
Facility address
1510 12TH Ave Road Suite 100
Nampa, ID 83686

National Provider Directory

National Provider Directory

Locations

1510 12th Ave Rd
Ste 100
Nampa, ID 83686
Phone (208) 498-1333

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1093245953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8686 NEW TRAILS DR STE 100",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773811176",
            "telephone_number": "713-637-1146",
            "fax_number": "281-298-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 12TH AVENUE RD",
            "address_2": "SUITE 100",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "83686",
            "telephone_number": "713-637-1146",
            "fax_number": "281-298-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMP IDAHO NAMPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-14",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "BUCK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "713-637-1004",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "ID",
            "license": "71",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "13-0072",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093245953",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint Alphonsus Neighborhood Hospital - South Nampa",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Saint Alphonsus Neighborhood Hospital - South Nampa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.