NPIMap

Organization Active NPI

Dirne Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Kellogg, ID
National Provider Identifier
1487076048
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
DIRNE HEALTH CENTERS, INC
Practice address
740 McKinley Ave
Kellogg, ID 83837-2693
Phone
(208) 783-1267
Fax
(844) 807-3782
NPI assigned
Jan 15, 2014
Organization subpart
Yes
Parent organization
DIRNE HEALTH CENTERS INCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Michael Baker
Title
Ceo
Phone
(208) 620-5200

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 10

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

Practitioners 83

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 83

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D0679491Heritage Health Kellogg740 McKinley Ave W, Kellogg, ID 83837Certificate of waiverOct 24, 2026

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050303001041 ID Part B Supplier - Clinic/Group Practice 2466353354 Receives reassigned benefits from 86 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: St Maries, ID; Rathdrum, ID; Post Falls, ID; Kellogg, ID; Coeur D Alene, ID; Coeur D'Alene, ID
O20140319000566 ID Part a Provider - Federally Qualified Health Center (FQHC) 2466353354 Practice locations: Kellogg, ID

Federally qualified health center certification: CCN 131856

Medicare enrollment files
Legal name
DIRNE HEALTH CENTERS, INC.
Doing business as
HERITAGE MOUNTAIN HEALTH SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 25, 2014
Last certification
Feb 25, 2014
Ownership / control type
Non-profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 17, 1986 in ID
Enrollment address
740 McKinley Ave
Kellogg, ID 83837-2693

All disclosed owners & managing parties 14

Medicare enrollment files

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

NameRoleSinceShare
Michael R Baker Individual Corporate OfficerCeo Dec 7, 2009
W-2 Managing EmployeeCeo Dec 7, 2009
Operational/Managerial ControlCeo Dec 7, 2009
Carl McMinimy Individual Corporate DirectorBoard Member Mar 1, 2019
Jana L Hull Individual Corporate DirectorBoard Member Sep 27, 2016
Linda Johan Individual Corporate DirectorBoard Member Feb 1, 2004
Paul Amador Individual Corporate DirectorBoard Member Jul 1, 2018
Brinnon Mandel Individual Corporate DirectorBoard Member Jan 1, 2015
Ann Spellman Dare Individual Corporate DirectorBoard Member Sep 27, 2016
Ron Beecher Individual Corporate DirectorBoard Member Jun 1, 2016
Ying Zhang Individual Corporate OfficerCfo - Delegated Official Jul 1, 2024
Elizabeth Montgomery Individual Corporate DirectorBoard Member Jan 29, 2025
Pamela Sue Bellatty Thompson Individual Corporate DirectorBoard Member Jan 29, 2025
George Rohlinger Individual Corporate DirectorBoard Member Jan 29, 2025
Michael Schmidt Individual Corporate DirectorBoard Member Feb 26, 2013
Bruce Cyr Individual Corporate DirectorBoard Member Jan 29, 2025

National Provider Directory

National Provider Directory
Part of
Dirne Health Centers Inc

Specialties & licenses 14

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
School CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YS0200X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Federally Qualified Health Center (FQHC) 261QF0400X ID Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

NPPES NPI Registry

Primary practice location

740 McKinley Ave
Kellogg, ID 83837-2693

Mailing address

PO Box 1387
Hayden, ID 83835-1387
Phone (208) 620-5200

Other names 1

NPPES NPI Registry
  • Heritage Health Kellogg Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 18, 2025.

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1487076048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1387",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838351387",
            "telephone_number": "208-620-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 MCKINLEY AVE",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "838372693",
            "telephone_number": "208-783-1267",
            "fax_number": "844-807-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRNE HEALTH CENTERS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIRNE HEALTH CENTERS INC",
        "enumeration_date": "2014-01-15",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-620-5200"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "ID",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Health Kellogg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kellogg, ID

Sources for this page

Verify at the official NPI Registry.