NPIMap

Organization Active NPI

Bonner General Hospital, Inc.

Doing business as Bonner General Hospital

  • General Acute Care Hospital
  • Sandpoint, ID
National Provider Identifier
1144287756
Registry record updated Mar 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
22 Issued in ID
Legal business name
BONNER GENERAL HOSPITAL, INC.
Doing business as
Bonner General Hospital
Practice address
520 N 3Rd Ave
Sandpoint, ID 83864-1507
Phone
(208) 265-1101
Fax
(208) 265-1277
NPI assigned
Apr 27, 2006
Last updated
Mar 16, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2010

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

Authorized official

Name
Sheryl Lynn Rickard
Title
Ceo
Phone
(208) 265-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 22 ID Primary

Addresses

Primary practice location

520 N 3Rd Ave
Sandpoint, ID 83864-1507

Mailing address

520 N 3Rd Ave
Sandpoint, ID 83864-1507
Phone (208) 265-1101

Other identifiers 15

IdentifierTypeStateIssuer
0146625OtherWADEPT OF LABOR 1500
3300423MedicaidWA
7027337MedicaidWA
000010004582OtherIDREGENCE BLUE SHIELD
7106958MedicaidWA
00067OtherIDBLUE CROSS UB92
000010004581OtherIDREGENCE BLUE SHIELD 1500
0354783MedicaidMT
8K388OtherIDBLUE CROSS 1500
000010004580OtherIDREGENCE BLUE SHIELD 1500
002274000MedicaidID
002406400MedicaidID
000010004583OtherIDREGENCE BLUE SHIELD UB92
0027647OtherWADEPT OF LABOR UB92
0410280MedicaidMT

Other names 1

  • Bonner General Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040626000014 ID Part B Supplier - Clinic/Group Practice 4082690466 Receives reassigned benefits from 75 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sandpoint, ID

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1144287756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N 3RD AVE",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641507",
            "telephone_number": "208-265-1101",
            "fax_number": "208-265-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N 3RD AVE",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641507",
            "telephone_number": "208-265-1101",
            "fax_number": "208-265-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNER GENERAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "RICKARD",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-265-1100"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "ID",
            "license": "22",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR  1500",
            "identifier": "0146625",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3300423",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7027337",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010004582",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7106958",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS   UB92",
            "identifier": "00067",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD  1500",
            "identifier": "000010004581",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0354783",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS  1500",
            "identifier": "8K388",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD 1500",
            "identifier": "000010004580",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002274000",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002406400",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD UB92",
            "identifier": "000010004583",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR  UB92",
            "identifier": "0027647",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0410280",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bonner General Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandpoint, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.