NPIMap

Organization Active NPI

Gritman Medical Center Inc

Doing business as Gritman Internal Medicine Clinic

  • Internal Medicine Physician
  • Moscow, ID
National Provider Identifier
1235680703
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
39 Issued in ID
Legal business name
GRITMAN MEDICAL CENTER INC
Doing business as
Gritman Internal Medicine Clinic
Practice address
2400 W a St Ste G
Moscow, ID 83843-4902
Phone
(208) 883-1152
Fax
(208) 882-1486
NPI assigned
Oct 20, 2016
Last updated
Sep 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Authorized official

Name
Mr. Kara Besst
Title
Ceo
Phone
(208) 882-4511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 39 ID Primary

Addresses

Primary practice location

2400 W a St Ste G
Moscow, ID 83843-4902

Mailing address

PO Box 8007
Moscow, ID 83843-0507
Phone (208) 883-1152

Other names 1

  • Gritman Internal Medicine Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20161130002249 ID Part B Supplier - Clinic/Group Practice 4981984390 Receives reassigned benefits from 29 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Moscow, ID
O20201020001059 ID Part A Provider - Rural Health Clinic 4981984390 Practice locations: Moscow, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235680703. Details of each certification follow.

Rural health clinic certification: CCN 138535

Legal name
GRITMAN MEDICAL CENTER INC
Doing business as
GRITMAN INTERNAL MEDICINE CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 4, 2021
Last certification
Nov 4, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jul 5, 1991 in ID
Enrollment address
719 S Main St
Moscow, ID 83843-3041
Related CCNs
131327

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

Other NPIs with the same Medicare PAC ID 3

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.

National Provider Directory

National Provider Directory
Tax ID family
Gritman Medical Center Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Kraig a White Individual Corporate DirectorChair May 24, 2019
Danielle M Lynas Individual Corporate OfficerCfo Oct 1, 2020
Kara Besst Individual Corporate OfficerCeo/President Oct 1, 2020
Lori Stinson Individual Corporate DirectorVice Chair Oct 1, 2020
Danielle M Breed Individual Contracted Managing EmployeeAdministrative Chief of Staff Oct 1, 2020

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789344000000",
    "number": "1235680703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8007",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838430507",
            "telephone_number": "208-883-1152",
            "fax_number": "208-883-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W A ST STE G",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838434902",
            "telephone_number": "208-883-1152",
            "fax_number": "208-882-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRITMAN MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A",
        "authorized_official_last_name": "BESST",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-882-4511",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gritman Internal Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moscow, ID

Sources for this page

Verify at the official NPI Registry.