NPIMap

Organization Active NPI

St Joseph Hospital LLC

  • Internal Medicine Physician
  • Lewiston, ID
National Provider Identifier
1205368404
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ST JOSEPH HOSPITAL LLC
Practice address
415 6TH Street
Physician Services
Lewiston, ID 83501-8350
Phone
(208) 750-7462
NPI assigned
Mar 28, 2017
Last updated
Jun 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

415 6TH Street
Physician Services
Lewiston, ID 83501-8350

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000

Other practice location 1

341 Saint Johns Way
Lewiston, ID 83501-2436
Phone (615) 844-9800

Other identifiers 1

IdentifierTypeStateIssuer
1205368404MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, AZ, TX, OH4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20170606002496 ID Part B Supplier - Clinic/Group Practice 8325325806 Receives reassigned benefits from 171 practitioners
Practice locations: Lewiston, ID; Pocatello, ID; Moscow, ID; Grangeville, ID
O20230516002406 AZ Part B Supplier - Clinic/Group Practice 8325325806 Receives reassigned benefits from 1 practitioner
Practice locations: Oro Valley, AZ
O20230518001345 TX Part B Supplier - Clinic/Group Practice 8325325806 Receives reassigned benefits from 2 practitioners
Practice locations: Carrollton, TX; Frisco, TX
O20240131003036 OH Part B Supplier - Clinic/Group Practice 8325325806 Receives reassigned benefits from 6 practitioners
Practice locations: Westerville, OH

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory

Locations

1250 Idaho St
Lewiston, ID 83501
Phone (208) 743-7427

1630 23rd Ave
Ste 701
Lewiston, ID 83501
Phone (208) 743-3998

222 Southway Ave
#2B
Lewiston, ID 83501
Phone (208) 799-5370

222 Southway Ave
Ste 2A
Lewiston, ID 83501
Phone (208) 750-3840

222 Southway Ave
Ste 2B
Lewiston, ID 83501
Phone (208) 799-5370

307 Saint Johns Way
Ste 12
Lewiston, ID 83501
Phone (208) 746-5500

307 Saint Johns Way
Ste 2
Lewiston, ID 83501
Phone (208) 799-5294

307 Saint Johns Way
Ste 7
Lewiston, ID 83501
Phone (208) 743-8585

307 Saint Johns Way
Ste 9
Lewiston, ID 83501
Phone (208) 746-7055

3315 8th St
Lewiston, ID 83501
Phone (208) 743-9543

3316 4th St
Ste 4B
Lewiston, ID 83501
Phone (208) 746-2663

341 Saint Johns Way
Lewiston, ID 83501
Phone (208) 750-7462

415 6th St
Ste 3C
Lewiston, ID 83501
Phone (208) 750-7300

500 8th Ave
Rm 205
Lewiston, ID 83501
Phone (208) 792-2251

1174 Alturas Dr
Moscow, ID 83843
Phone (208) 743-3523

1245 S Sunbury Rd
Westerville, OH 43081

1245 S Sunbury Rd
Ste 101
Westerville, OH 43081
Phone (614) 706-3495

835 SE Bishop Blvd
Pullman, WA 99163
Phone (509) 332-2541

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
St Joseph Regional Medical CenterLewiston, ID, CCN 13T003 Hospital 5% Or Greater Indirect Ownership Interest Mar 17, 2025

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 182

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 182

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780531200000",
    "number": "1205368404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 6TH STREET",
            "address_2": "PHYSICIAN SERVICES",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835018350",
            "telephone_number": "208-750-7462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "341 Saint Johns Way",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ID",
            "postal_code": "835012436",
            "country_code": "US",
            "telephone_number": "615-844-9800",
            "fax_number": "615-844-9883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST JOSEPH HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-28",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205368404",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.