Grande Ronde Hospital, Inc

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

14-0728 Issued in OR

Legal business name

GRANDE RONDE HOSPITAL, INC

Practice address

300 E Jefferson St Ste 101
Boise, ID 83712-6221

Phone

(208) 336-4141

Fax

(208) 336-4035

NPI assigned

Jan 17, 2007

Organization subpart

No

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

Authorized official

Name

Mr. James Mattes

Title

President Ceo

Phone

(541) 963-1454

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302134400000",
    "number": "1497807812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3290",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978507290",
            "telephone_number": "541-963-1555",
            "fax_number": "541-963-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E JEFFERSON ST STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126221",
            "telephone_number": "208-336-4141",
            "fax_number": "208-336-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANDE RONDE HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2011-04-07",
        "status": "A",
        "authorized_official_last_name": "MATTES",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "541-963-1454",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "14-0728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Graham, RD
• Julie Ann Gramer, M.ED, LMFT
• Michael Alexander Gramlich, PH.D.
• Raymond William Grams II, D.O.
• Kenneth John Gramyk, M.D.
• Caitlin Grandfield, LCGC
• Grandmas Care Home Inc
• Brooklyn McNeil Grange
• Clarissa Dawn Grange, LMSW
• Daniel Lee Grange, D.O.

• Cardiovascular Disease Physician in Boise, ID
• Providers in Boise, ID by specialty
• Cardiovascular Disease Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.