NPIMap

Organization Active NPI

Syringa General Hospital District C I F

Doing business as Syringa General Hospital Hospice

  • Community Based Hospice Care Agency
  • Grangeville, ID
National Provider Identifier
1225162019
Registry record updated Feb 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SYRINGA GENERAL HOSPITAL DISTRICT C I F
Doing business as
Syringa General Hospital Hospice
Practice address
607 W Main St
Grangeville, ID 83530-1345
Phone
(208) 983-1700
Fax
(208) 983-8520
NPI assigned
Mar 15, 2007
Last updated
Feb 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2025

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

Authorized official

Name
David Applewood
Title
Chief Financial Officer
Phone
(208) 983-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

607 W Main St
Grangeville, ID 83530-1345

Mailing address

607 W Main St
Grangeville, ID 83530-1345
Phone (208) 983-1700

Other identifiers 1

IdentifierTypeStateIssuer
H0325OtherIDBLUE CROSS PROVIDER NUMBE

Other names 1

  • Syringa General Hospital Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050720001072 ID Part A Provider - Hospice 6800707530 Practice locations: Grangeville, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225162019. Details of each certification follow.

Hospice certification: CCN 131534

Legal name
SYRINGA GENERAL HOSPITAL DISTRICT C I F
Doing business as
SYRINGA GENERAL HOSPITAL HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 2, 1997
Last certification
May 26, 2022
Ownership / control type
Government - County
Organization structure
OtherNon-profit
Enrollment address
607 W Main St
Grangeville, ID 83530-1345

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Syringa General Hospital HospiceCCN 131534 · All quality measures
Ownership
Other
Certified
Dec 2, 1997
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Syringa General Hospital District Cif11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

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
Charlene Boyer Individual W-2 Managing EmployeeCeo Mar 2, 2026
Randall J Nightengale Individual W-2 Managing EmployeeCfo Apr 9, 2026
David E McKnight Individual Corporate DirectorBoard of Directors Jun 24, 2025
James J Paradiso Individual Corporate DirectorBoard of Directors Jun 24, 2025
Logan Staples Individual Corporate DirectorBoard of Directors Feb 25, 2025
Gunther M Williams Individual Corporate DirectorBoard of Directors Jun 24, 2025
Terri Tackett Individual Corporate DirectorBoard of Directors Jun 25, 2024
Jane M Carlson Individual Corporate DirectorBoard Member Jan 1, 2018
Syringa General Hospital District C I F Organization, Grangeville, ID Operational/Managerial Control Jan 1, 2018
Gerald W Zumwalt Individual Corporate DirectorBoard Member Jan 1, 2018
Laura Smith Individual Corporate DirectorBoard of Directors Jun 25, 2019

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Syringa General HospitalGrangeville, ID, CCN 131315 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 5, 2007
Syringa General HospitalGrangeville, ID, CCN 13Z315 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1975
Syringa Hospital & ClinicsGrangeville, ID, CCN 138517 Rural health clinic Operational/Managerial Control Jan 1, 2018
Syringa Hospital & ClinicsKooskia, ID, CCN 138518 Rural health clinic Operational/Managerial Control Jan 1, 2018

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 12

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

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739664000000",
    "number": "1225162019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 W MAIN ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835301345",
            "telephone_number": "208-983-1700",
            "fax_number": "208-983-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 W MAIN ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835301345",
            "telephone_number": "208-983-1700",
            "fax_number": "208-983-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYRINGA GENERAL HOSPITAL DISTRICT C I F",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A",
        "authorized_official_last_name": "APPLEWOOD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "208-983-1700"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "H0325",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Syringa General Hospital Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grangeville, ID

Sources for this page

Verify at the official NPI Registry.