NPIMap

Organization Active NPI

Bonner General Hospital Inc.

Doing business as Bonner General Health

  • Critical Access Hospital
  • Sandpoint, ID
National Provider Identifier
1154563963
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
22 Issued in ID
Legal business name
BONNER GENERAL HOSPITAL INC.
Doing business as
Bonner General Health
Practice address
520 N 3Rd Ave
Sandpoint, ID 83864-1507
Phone
(208) 263-1441
Fax
(208) 265-1277
NPI assigned
Mar 26, 2009
Last updated
Mar 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Authorized official

Name
John Hennessy
Title
Ceo
Phone
(208) 265-1100

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU
Critical Access Hospital 282NC0060X 22 ID Primary
Emergency Medicine Physician 207P00000X NU

Addresses

Primary practice location

520 N 3Rd Ave
Sandpoint, ID 83864-1507

Mailing address

PO Box 1343
Sandpoint, ID 83864-0863
Phone (208) 265-1158

Other names 1

  • Bonner General Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID3 enrollments

Enrollment records 3

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
Practice locations: Sandpoint, ID
O20090511000185 ID Part A Provider - Critical Access Hospital 4082690466 Receives reassigned benefits from 72 practitioners
Practice locations: Sandpoint, ID
O20240423002212 ID Part A Provider - Critical Access Hospital 4082690466 Practice locations: Sandpoint, ID

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1154563963. Details of each certification follow.

Hospital certification: CCN 131328

Legal name
BONNER GENERAL HOSPITAL INC
Doing business as
BONNER GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2010
Last certification
Oct 1, 2010
Beds
48 (25 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jul 13, 1949 in ID
Enrollment address
520 N 3Rd Ave
Sandpoint, ID 83864-1507
Main/Primary Hospital Location

Hospital certification: CCN 13Z328

Legal name
BONNER GENERAL HOSPITAL INC
Doing business as
BONNER GENERAL HEALTH
Organization structure
CorporationNon-profit
Enrollment address
520 N Third Ave
Sandpoint, ID 83864-1507
Hospital Swing-Bed Unit

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Bonner General HospitalCCN 131328 · All quality measures
Overall star rating
2 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
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
13D0522371Bonner General Health520 N Third Ave, Sandpoint, ID 83864ComplianceFeb 22, 2028

National Provider Directory

National Provider Directory
Tax ID family
Bonner General Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

314 E Albeni Hwy
Ste 102
Priest River, ID 83856
Phone (208) 448-2321

1029 MT Highway 200
Noxon, MT 59853
Phone (406) 847-2100

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Margaret J Gunter Individual Corporate DirectorBoard Member Mar 25, 2022
John P Hennessy Individual Corporate OfficerCeo Sep 15, 2014
W-2 Managing Employee Sep 15, 2014
Corporate OfficerCeo Sep 14, 2014
Scott a Burgstahler Individual Corporate DirectorBoard Member Apr 1, 2012
Jim Frank Individual Corporate Director May 1, 2015
Barton Casey Individual Corporate DirectorBoard Member Feb 1, 2016
Deirdre Baumgartner Individual W-2 Managing EmployeeDirector Patient Financial Servi May 10, 2009
Michelle M Anderson Individual Corporate DirectorBoard Member Jul 1, 2016
John Elsaesser Individual Corporate DirectorBoard Chairman Mar 10, 2009
Tim Cochran Individual Corporate DirectorVice Chairman Mar 10, 2009
Barbara Buchanan Individual Corporate DirectorBoard Member Mar 24, 2023
Thomas L Lawrence Individual Corporate DirectorBoard Secretary Mar 10, 2009

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bonner Community HospiceSandpoint, ID, CCN 131514 Hospice Operational/Managerial Control Jul 22, 1992

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 90

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 90

Affiliated clinicians 329

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

View all 329

NPI Registry JSON

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

{
    "created_epoch": "1238025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1154563963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1343",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838640863",
            "telephone_number": "208-265-1158",
            "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": "208-263-1441",
            "fax_number": "208-265-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNER GENERAL HOSPITAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-26",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "HENNESSY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-265-1100"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "ID",
            "license": "22",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bonner General Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bonner General Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandpoint, ID

Sources for this page

Verify at the official NPI Registry.