St. Joseph Hospital, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ST. JOSEPH HOSPITAL, LLC

Practice address

415 6TH St
Lewiston, ID 83501-2431

Phone

(208) 799-5200

Fax

(208) 799-5554

NPI assigned

Feb 6, 2007

Last updated

Jun 23, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Johnetta Traylor

Title

Ao

Phone

(502) 596-6063

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Member of 1

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

• St. Joseph Hospital, LLC

  dba St. Joseph Regional Medical Center

  • Rehabilitation Hospital Unit
  • Lewiston, ID
  • NPI 1629783295

  Member Of

  NPD member

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Idaho in-Home Partner-I, LLC

  dba Heart 'n Home Hospice

  • Community Based Hospice Care Agency
  • Lewiston, ID
  • NPI 1326697558

  Sold to, 2019-12-01

  CMS change of ownership

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1114066768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S 4TH ST # KH-3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407",
            "telephone_number": "502-596-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 6TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012431",
            "telephone_number": "208-799-5200",
            "fax_number": "208-799-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "TRAYLOR",
        "authorized_official_first_name": "JOHNETTA",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "502-596-6063"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805059500",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS IDAHO HOSPICE",
            "identifier": "H0176",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS HOSPICE",
            "identifier": "820204264-011",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St Joseph Hospital LLC (St. Joseph Regional Medical Group)
• St Joseph Hospital LLC
• St Joseph SNF Unit
• Jackie St Marie, SLP
• St. Joseph Hospital LLC (St. Joseph Regional Medical Center)
• St. Joseph Hospital, LLC
• St. Joseph Hospital, LLC (St. Joseph Regional Medical Center)
• St. Joseph Regional Medical Center (St. Joseph Medical Group)
• St. Joseph Regional Medical Center
• St. Joseph Regional Medical Center (St. Joseph Orthopaedic Care)

• Community Based Hospice Care Agency in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Community Based Hospice Care Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.