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St. Mary'S Hospital Inc

Organization Active NPI Family Nurse Practitioner · Cottonwood, ID

NPI 1568633592 · NPPES record last updated Aug 10, 2026

Key facts

NPI
1568633592
Entity type
Organization (NPI type 2)
Primary specialty
Family Nurse Practitioner 363LF0000X
Legal business name
ST. MARY'S HOSPITAL INC
Practice address
701 Lewiston Street
Cottonwood, ID 83522-0565
Phone
(208) 962-3267
Fax
(208) 962-2313
NPI assigned
Mar 18, 2008
Organization subpart
Yes
Parent organization (as reported)
KOOTENAI HEALTH, INC.

Authorized official

Name
Lenne Bonner
Title
Ceo
Phone
(208) 476-8008

Corporate family (same tax ID) 13

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

Practitioners 1

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

National Provider Directory

Tax ID family
St Mary'S Clinic (14 organizations share this tax ID)
Part of
St Mary'S Clinic

Locations

701 Lewiston St
Cottonwood, ID 83522
Phone (208) 962-3251

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 363LF0000X ID Yes

Addresses

Primary practice location

701 Lewiston Street
Cottonwood, ID 83522-0565

Mailing address

PO Box 565
Cottonwood, ID 83522-0565
Phone (208) 962-3267

Other identifiers

IdentifierTypeStateIssuer
805066400MedicaidID

Other names

  • St. Mary's Clinics Midlevel Group Doing business as

Other providers in Cottonwood, ID

All providers in Cottonwood, ID · Family Nurse Practitioner in Idaho

Sources for this page

Verify at the official NPI Registry.