Southwest Idaho Advanced Care Hospital Inc -a Delaware Corp-

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

Legal business name

SOUTHWEST IDAHO ADVANCED CARE HOSPITAL INC -A DELAWARE CORP-

Practice address

6651 W Franklin Rd
Boise, ID 83709

Phone

(505) 856-5300

NPI assigned

Sep 11, 2007

Organization subpart

No

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

Authorized official

Name

Claude Darby Brockette

Title

Ceo

Phone

(505) 856-5300

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 130069

Legal name

SOUTHWEST IDAHO ADVANCED CARE HOSPITAL

Certification status

Terminated Voluntary: merger or closure, Dec 31, 2008

Provider type (POS)

Hospital – Short-term

Participating since

Jun 3, 2008

Last certification

May 2, 2008

Beds

40

Ownership / control type

Private (for profit)

Facility address

6651 West Franklin Road
Boise, ID 83709

Hospital certification: CCN 132003

Legal name

SOUTHWEST IDAHO ADVANCED CARE HOSPITAL

Certification status

Terminated Voluntary: other reason for withdrawal, Feb 4, 2018

Provider type (POS)

Hospital – Long-term

Participating since

Jan 1, 2009

Last certification

Jan 1, 2009

Beds

40

Ownership / control type

Private (not for profit)

Facility address

6651 West Franklin Road
Boise, ID 83709

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502928000000",
    "number": "1114112216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6651 W FRANKLIN RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709",
            "telephone_number": "505-856-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6651 W FRANKLIN RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709",
            "telephone_number": "505-856-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST IDAHO ADVANCED CARE HOSPITAL INC -A DELAWARE CORP-",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2017-08-17",
        "status": "A",
        "authorized_official_last_name": "BROCKETTE",
        "authorized_official_first_name": "CLAUDE",
        "authorized_official_middle_name": "DARBY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-856-5300"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Long Term Care Hospital in Boise, ID
• Providers in Boise, ID by specialty
• Long Term Care Hospital in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2017; 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.