NPIMap

Organization Active NPI

North Idaho Day Surgery LLC

  • Multi-Specialty Clinic/Center
  • St Maries, ID
National Provider Identifier
1093674301
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
NORTH IDAHO DAY SURGERY LLC
Practice address
622 W College Ave Ste 2
St Maries, ID 83861-1822
Phone
(208) 568-7800
Fax
(877) 902-7131
NPI assigned
Jan 21, 2026
Last updated
Mar 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Authorized official

Name
Jason Bell
Title
Payer Enrollment Specialist
Phone
(208) 618-2559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

622 W College Ave Ste 2
St Maries, ID 83861-1822

Mailing address

1593 E Polston Ave
Post Falls, ID 83854-5326
Phone (208) 262-2300

Other identifiers 1

IdentifierTypeStateIssuer
1104824739MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030826000037 ID Part A Provider - Hospital 0840101218 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Maries, ID; Rathdrum, ID; Post Falls, ID; Kellogg, ID; Coeur D Alene, ID; Athol, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093674301. Details of each certification follow.

Hospital certification: CCN 130066

Legal name
NORTH IDAHO DAY SURGERY LLC
Doing business as
NORTHWEST SPECIALTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Oct 16, 2003
Last certification
Feb 6, 2026
Beds
34
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Dec 12, 2001 in ID
Enrollment address
1593 E Polston Ave
Post Falls, ID 83854-5326
Main/Primary Hospital Location
Hospital subgroups
Specialty hospital

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Northwest Specialty HospitalCCN 130066 · All quality measures
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
North Idaho Day Surgery LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
SP Holdco I Inc Organization, Brentwood, TN Corporation, For-profit 5% Or Greater Indirect Ownership Interest May 16, 2021 67.35%
National Surgical Hospitals, LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest May 16, 2021 57.9%
Sgry Holdings, LP Organization, Brentwood, TN Holding company, For-profit 5% Or Greater Indirect Ownership Interest May 26, 2021 9.45%
Jennifer B Baldock Individual Corporate OfficerOfficer and Authorized Official Sep 1, 2017
FMR LLC Organization, Boston, MA LLC 5% Or Greater Indirect Ownership Interest Nov 21, 2022 8.89%
SP Management Services Inc Organization, Brentwood, TN Corporation, For-profit Operational/Managerial Control Sep 17, 2020 100%
Bcpe Seminole Holdings, LP Organization, Boston, MA For-profit 5% Or Greater Indirect Ownership Interest May 16, 2021 20.21%
Sgry, LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest May 26, 2021 9.45%
Rick S Rasmussen Individual Corporate OfficerCeo Jul 1, 2012
W-2 Managing EmployeeCeo Jul 1, 2012
Surgery Partners Inc Organization, Brentwood, TN Corporation, For-profit 5% Or Greater Indirect Ownership Interest Sep 17, 2020 67.35%
Mountain View Hospital LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Sep 17, 2020 13.63%
Surgery Center Holdings Inc Organization, Brentwood, TN For-profit, Chain home office 5% Or Greater Indirect Ownership Interest Sep 17, 2020 67.35%
NSH North Idaho, LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Direct Ownership Interest Sep 17, 2020 57.9%
MVH NWSH LLC Organization, Brentwood, TN Created for acquisition, LLC, For-profit 5% Or Greater Direct Ownership Interest Sep 17, 2020 13.63%
Harrison R Bane Individual OtherNatl GRP Pres & Chain Home Off Admn Sep 1, 2024
Symbion Holdings LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest May 26, 2021 9.45%
Smbi Idaho LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest May 26, 2021 9.45%
Roger C Dunteman Individual 5% Or Greater Direct Ownership Interest Sep 17, 2020 7%
Surgery Center Holdings LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Sep 17, 2020 67.35%

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 385

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

View all 385

NPI Registry JSON

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

{
    "created_epoch": "1768953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1093674301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545326",
            "telephone_number": "208-262-2300",
            "fax_number": "208-262-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W COLLEGE AVE STE 2",
            "city": "ST MARIES",
            "state": "ID",
            "postal_code": "838611822",
            "telephone_number": "208-568-7800",
            "fax_number": "877-902-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH IDAHO DAY SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-21",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PAYER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "208-618-2559"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104824739",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Maries, ID

Sources for this page

Verify at the official NPI Registry.