Grande Ronde Hospital, Inc

Primary specialty

Sleep Medicine (Family Medicine) PhysicianTaxonomy code 207QS1201X

Legal business name

GRANDE RONDE HOSPITAL, INC

Practice address

1717 Arlington Ave
Caldwell, ID 83605-4802

Phone

(208) 367-4817

NPI assigned

Sep 22, 2015

Organization subpart

No

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

Authorized official

Name

Mr. James A Mattes

Title

President/Ceo

Phone

(541) 963-1842

Specialties & licenses 1

Addresses

Other names 1

• GRANDE RONDE HOSPITAL SLEEP CLINIC -CALDWELL Doing business as

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442880000000",
    "number": "1194194902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3290",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978507290",
            "telephone_number": "541-963-8421",
            "fax_number": "541-963-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 ARLINGTON AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054802",
            "telephone_number": "208-367-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANDE RONDE HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-22",
        "last_updated": "2015-09-22",
        "status": "A",
        "authorized_official_last_name": "MATTES",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "541-963-1842",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QS1201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRANDE RONDE HOSPITAL SLEEP CLINIC -CALDWELL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Justin Dwight Goodrich, PHARMD
• Mary Kay Gordon-Brunner
• Artoun Gostantian
• Joshua Paul Goyden, PA-C
• Grace at Caldwell LLC
• Hailey Kim Thu Graviet, MD
• Lisa Kay Gray, LMSW
• Dawn Marie Green, LPC
• Grillz
• Haley Gross

• Sleep Medicine (Family Medicine) Physician in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Sleep Medicine (Family Medicine) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.