NPIMap

Organization Active NPI

Idaho Falls Community Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
National Provider Identifier
1114481447
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
IDAHO FALLS COMMUNITY HOSPITAL LLC
Practice address
2327 Coronado St
Idaho Falls, ID 83404-7407
Phone
(208) 528-1000
NPI assigned
Jan 31, 2019
Last updated
Jan 31, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Authorized official

Name
Ned Hillyard
Title
Chief Compliance Officer
Phone
(208) 709-4571

Specialties & licenses 1

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

Addresses

Primary practice location

2327 Coronado St
Idaho Falls, ID 83404-7407

Mailing address

2327 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 528-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20191101001944 ID Part A Provider - Hospital 9032441597 Practice locations: Idaho Falls, ID
O20191217002564 ID Part B Supplier - Clinic/Group Practice 9032441597 Receives reassigned benefits from 20 practitioners
Practice locations: Idaho Falls, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114481447. Details of each certification follow.

Hospital certification: CCN 130074

Legal name
IDAHO FALLS COMMUNITY HOSPITAL LLC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 24, 2019
Last certification
Dec 4, 2025
Beds
88
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Enrollment address
2327 Coronado St
Idaho Falls, ID 83404-7407
Other Hospital Practice Location
Hospital subgroups
General

Care Compare: Hospital

Medicare Care Compare
Listed as
Idaho Falls Community Hospital, LLCCCN 130074 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2173071Idaho Falls Community Hospital2327 Coronado St, Idaho Falls, ID 83404ComplianceJan 13, 2027

National Provider Directory

National Provider Directory

Member of 1

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

Locations

859 S Yellowstone Hwy
Ste 3302
Rexburg, ID 83440
Phone (208) 656-2160

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Ihc Health Services Inc Organization, Salt Lake City, UT Corporation 5% Or Greater Direct Ownership Interest Mar 31, 2023 20%
Casey Jackman Individual Corporate OfficerChief Administrative Officer Nov 1, 2019
Corporate Director Nov 1, 2019
W-2 Managing Employee Nov 1, 2019
Operational/Managerial Control Nov 1, 2019
Smbi Idaho LLC Organization, Brentwood, TN LLC 5% Or Greater Direct Ownership Interest Nov 1, 2019 80%
Ned Hillyard Individual Corporate Officer Nov 1, 2019
Corporate Director Nov 1, 2019
W-2 Managing Employee Nov 1, 2019

Facilities with the same owner 32

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 32

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

Affiliated clinicians 238

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

View all 238

NPI Registry JSON

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548892800000",
    "number": "1114481447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2327 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047407",
            "telephone_number": "208-528-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2327 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047407",
            "telephone_number": "208-528-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO FALLS COMMUNITY HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A",
        "authorized_official_last_name": "HILLYARD",
        "authorized_official_first_name": "NED",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "208-709-4571"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.