NPIMap

Organization Active NPI

St. Mary's Hospital Inc

Doing business as St. Mary's Clinics Midlevel Group

  • Family Nurse Practitioner
  • Cottonwood, ID
National Provider Identifier
1568633592
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
ST. MARY'S HOSPITAL INC
Doing business as
St. Mary's Clinics Midlevel Group
Practice address
701 Lewiston Street
Cottonwood, ID 83522-0565
Phone
(208) 962-3267
Fax
(208) 962-2313
NPI assigned
Mar 18, 2008
Last updated
Aug 10, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
KOOTENAI HEALTH, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X ID Primary

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 names 1

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

National Provider Directory

National Provider Directory
Tax ID family
Kenneth Pfaff MD14 organizations share this tax ID, including this one
Part of
Kootenai Health Inc

Other organizations with this tax ID 13

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

View all 13

Practitioners & affiliated clinicians

Practitioners 1

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": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1568633592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 565",
            "city": "COTTONWOOD",
            "state": "ID",
            "postal_code": "835220565",
            "telephone_number": "208-962-3267",
            "fax_number": "208-962-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 LEWISTON STREET",
            "city": "COTTONWOOD",
            "state": "ID",
            "postal_code": "835220565",
            "telephone_number": "208-962-3267",
            "fax_number": "208-962-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOOTENAI HEALTH, INC.",
        "enumeration_date": "2008-03-18",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "BONNER",
        "authorized_official_first_name": "LENNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-476-8008"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Mary's Clinics Midlevel Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cottonwood, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.