NPIMap

Organization Active NPI

Eastern Idaho Health Services Inc

Doing business as Eastern Idaho Regional Medical Center

  • General Acute Care Hospital
  • Idaho Falls, ID
National Provider Identifier
1225082209
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
EASTERN IDAHO HEALTH SERVICES INC
Doing business as
Eastern Idaho Regional Medical Center
Practice address
3100 Channing Way
Idaho Falls, ID 83404-7533
Phone
(208) 529-6111
Fax
(208) 529-7021
NPI assigned
May 22, 2006
Last updated
Nov 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Authorized official

Name
Aaron Martin
Title
Cfo
Phone
(208) 529-6109

Specialties & licenses 1

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

Addresses

Primary practice location

3100 Channing Way
Idaho Falls, ID 83404-7533

Mailing address

3100 Channing Way
P.O. Box 2077
Idaho Falls, ID 83404-7533
Phone (208) 529-6111

Other identifiers 11

IdentifierTypeStateIssuer
091843MedicaidOR
3020989MedicaidWA
HS848IPMedicaidAK
0414336MedicaidMT
114794300MedicaidWY
022575MedicaidAZ
1188039MedicaidNV
2614200MedicaidID
XHSP31065MedicaidCA
000010006678OtherIDBLUE SHIELD
00315OtherIDBLUE CROSS

Other names 1

  • EASTERN IDAHO REGIONAL MEDICAL CENTER Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network
Direct Messaging Address EASTERNIDAHO.COCID.IDA@CCDA.HCADIRECT.NET

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000477 ID Part A Provider - Hospital 5597662981 Practice locations: Idaho Falls, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225082209. Details of each certification follow.

Hospital certification: CCN 130018

Legal name
EASTERN IDAHO HEALTH SERVICES INC
Doing business as
EASTERN IDAHO REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 24, 2025
Beds
330
Ownership / control type
Private (for profit)
Most recent change of ownership
Apr 30, 1990 (3 total)
Organization structure
CorporationProprietary
Enrollment address
3100 Channing Way
Idaho Falls, ID 83404-7533
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Eastern Idaho Regional Medical CenterCCN 130018 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Eastern Idaho Health9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Interoperability endpoints

  • Direct secure messaging: easternidaho.cocid.ida@ccda.hcadirect.net

Ownership & related parties

All disclosed owners & managing parties 38

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

NameRoleSinceShare
Kevin McKeown Individual Corporate OfficerDivision Cfo Apr 6, 2026
W-2 Managing EmployeeDivision Cfo Apr 6, 2026
Michael McAlevey Individual Corporate Officer Feb 1, 2022
Jaime L Derensis Individual Corporate Officer Nov 4, 2020
HCA Inc Organization, Nashville, TN Corporation 5% Or Greater Indirect Ownership Interest Apr 30, 2007 100%
John M Franck Individual Corporate Director Apr 30, 2007
Douglas L Downey Individual Corporate Officer Apr 7, 2014
Eric D Smith Individual Contracted Managing EmployeeVice President of Reimbursement Mar 1, 2021
HCA Healthcare Inc Organization, Nashville, TN Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest May 8, 2017 100%
Kristopher D Russell Individual Corporate OfficerCfo Dec 30, 2025
W-2 Managing EmployeeCfo Dec 30, 2025
Henry Todd Maxwell Individual Corporate Officer Jan 1, 2024
Frisco Holding II Organization, Wilmington, DE Corporation 5% Or Greater Indirect Ownership Interest Feb 6, 2026 16.3%
Evan Ray Individual Corporate Officer Mar 1, 2024
Christopher F Wyatt Individual Corporate DirectorSenior Vice President Apr 18, 2016
John I Starling Individual Corporate Officer Oct 7, 2019
Shirley E Scharf-Cheatham Individual Corporate Officer Jan 1, 2010
John M Hackett Individual Corporate Officer Apr 18, 2016
Hercules Holding II Organization, Nashville, TN Holding company, For-profit 5% Or Greater Indirect Ownership Interest Sep 30, 2016 18%
Samuel N Hazen Individual Corporate Director Jan 1, 2010
Ronald Lee Grubbs Individual Corporate Officer Jan 1, 2010
Elizabeth Hunsicker Individual Corporate OfficerVice President Feb 13, 2023
W-2 Managing EmployeeCeo Feb 13, 2023
Monica Cintado Individual Corporate Officer Oct 7, 2019
Jon Foster Individual Corporate OfficerSenior Vice President Jan 1, 2023
Healthtrust Inc - the Hospital Company Organization, Nashville, TN Corporation, For-profit 5% Or Greater Indirect Ownership Interest Apr 30, 2007 100%
Seth a Killingbeck Individual Corporate Officer Aug 10, 2012
Timothy Scott Noonan Individual Corporate Officer Apr 5, 2013
Natalie H Cline Individual Corporate Officer Apr 5, 2013
Michael T Bray Individual Corporate Officer Jan 1, 2010
Matthew R Favicchio Individual Corporate OfficerVice President Sep 5, 2025
Peter J Rossell Individual Corporate OfficerVice President Jan 1, 2023
Timothy M McManus Individual Corporate OfficerSenior Vice President Jan 1, 2023
Michael a Marks Individual Corporate OfficerSenior Vice President Sep 5, 2025
Edwin W Robinson Individual Corporate OfficerVice President Sep 5, 2025
Brad Ej Spicer Individual Corporate OfficerVice President Jan 1, 2023
Hti Hospital Holdings Inc Organization, Nashville, TN Corporation, For-profit 5% Or Greater Direct Ownership Interest Apr 30, 2007 100%
Kevin a Ball Individual Corporate Officer Apr 7, 2014
Jeffery McInturff Individual Corporate Officer Nov 29, 2021
Deborah H Mullin Individual Corporate Officer Jan 1, 2010
Russell Young Individual Corporate OfficerVice President Jan 1, 2023

Facilities with the same owner 132

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

View all 132

Practitioners & affiliated clinicians

Practitioners 11

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.

Affiliated clinicians 491

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

View all 491

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1225082209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "address_2": "P.O. BOX 2077",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-529-6111",
            "fax_number": "208-529-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-529-6111",
            "fax_number": "208-529-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN IDAHO HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "208-529-6109"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091843",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3020989",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HS848IP",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0414336",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114794300",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022575",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1188039",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2614200",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHSP31065",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010006678",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00315",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "EASTERNIDAHO.COCID.IDA@CCDA.HCADIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "Please contact CORP.HCACEP@HCAHealthcare.com for information regarding validation steps that may be required to ensure CCDs sent to the listed direct address are successfully received",
            "address_1": "3100 Channing Way",
            "city": "Idaho Falls",
            "state": "ID",
            "country_code": "US",
            "postal_code": "834047533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "EASTERN IDAHO REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EASTERN IDAHO REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.