NPIMap

Health West, Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Chubbuck, ID

NPI 1629499751 · NPPES record last updated Mar 2, 2017

Key facts

NPI
1629499751
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
HEALTH WEST, INC.
Practice address
880 W Quinn Rd
Chubbuck, ID 83202-2454
Phone
(208) 238-2000
Fax
(208) 238-8888
NPI assigned
Dec 16, 2013
Organization subpart
Yes
Parent organization (as reported)
HEALTH WEST, INC.

Authorized official

Name
Mindy Benedetti
Title
Ceo
Phone
(208) 232-7862

Owners & managing parties with NPI records 5

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

Other NPIs on the same Medicare enrollment 23

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

Practitioners 60

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

View all 60

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in ID

Federally qualified health center certification: CCN 131852

Legal name
HEALTH WEST INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 29, 2014
Last certification
Jan 29, 2014
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 1, 1975 in ID
Enrollment address
880 W Quinn Rd
Chubbuck, ID 83202-2454

All disclosed owners & managing parties 44

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

NameRoleSinceShare
Pamela Sanderson
Individual 		Corporate Director
Board Member		 Jun 26, 2017
Ashley Kleinsmith
Individual 		W-2 Managing Employee
Dental Team Lead		 Nov 17, 2014
Derrik Jones
Individual 		W-2 Managing Employee
Pocatello Clinic Administrator		 Jul 7, 2014
Gabriel Rivas
Individual 		Corporate Director
Board Member		 Mar 31, 2014
Lori Seaton
Individual 		W-2 Managing Employee
Behavioral Health Program Manager		 Oct 16, 2009
Alexander Lemmon
Individual 		W-2 Managing Employee
Ab & Af Clinic Administrator		 Apr 26, 2017
Aubrey Cooley
Individual 		W-2 Managing Employee
Revenue Cycle Manager		 Apr 2, 2014
Elaine Downs
Individual 		W-2 Managing Employee
Patient Service Rep Supervisor		 Aug 14, 2017
Heather Schaper
Individual 		W-2 Managing Employee
Mid-Level Director		 Sep 1, 2009
Andrea Smart
Individual 		Corporate Director
Board Member		 Jul 31, 2017
Doug Mathis
Individual 		Corporate Director
Board Member		 Jul 27, 2015
Iris Buder
Individual 		Corporate Director
Board Member		 Nov 23, 2015
Stephanie Heaton
Individual 		Corporate Director
Director of Grants and Special Prog		 Apr 8, 2013
W-2 Managing Employee
Director of Grants and Special Prog		 Apr 8, 2013
Mark T Horrocks
Individual 		Corporate Officer
Chief Medical Officer		 Oct 31, 2002
W-2 Managing Employee
Chief Medical Officer		 Oct 31, 2002
Jordan Smith
Individual 		W-2 Managing Employee
South Clinic Administrator		 Jun 20, 2017
Connie Moser
Individual 		W-2 Managing Employee
Isu Clinic Administrator		 Mar 31, 2014
Larry Burden
Individual 		Corporate Director
Board Member		 Jun 26, 2017
Gino Piva
Individual 		Corporate Director
Director of Pharmacy		 Oct 20, 2017
W-2 Managing Employee
Director of Pharmacy		 Oct 20, 2017
Jeremy Smuin
Individual 		Corporate Director
Director of Compliance		 Jan 1, 2013
W-2 Managing Employee
Director of Compliance		 Jan 1, 2013
Debra Hemmert
Individual 		Corporate Director
Board Member		 Jun 26, 2017
Norma Hartley
Individual 		Corporate Director
Director of Human Resources		 Jul 29, 2013
W-2 Managing Employee
Director of Human Resources		 Jul 29, 2013
Robert Picard
Individual 		Corporate Director
Board Treasurer		 Feb 25, 2013
Joseph Neil Ragan
Individual 		Corporate Director
Residency Medical Director		 Jan 1, 2013
W-2 Managing Employee
Residency Medical Director		 Jan 1, 2013
Alan Sudweeks
Individual 		W-2 Managing Employee
It Manager		 Feb 16, 2016
Sheri Hill
Individual 		W-2 Managing Employee
South Clinic Team Lead		 Apr 6, 2016
Amber Campbell
Individual 		W-2 Managing Employee
Nurse Manager		 Aug 16, 2010
Clark Geslin
Individual 		Corporate Officer
Chief Information Officer		 Dec 14, 2009
W-2 Managing Employee
Chief Information Officer		 Dec 14, 2009
Paul Morgan
Individual 		Corporate Officer
Chief Financial Officer		 Jul 10, 2017
W-2 Managing Employee
Chief Financial Officer		 Jul 10, 2017
Lyn N McArthur
Individual 		Corporate Director
Director of Behavioral Health		 Jul 16, 2013
W-2 Managing Employee
Director of Behavioral Health		 Jul 16, 2013
Roni Hobson
Individual 		W-2 Managing Employee
Chubbuck Clinic Administrator		 Mar 15, 2010
Shannon Koester
Individual 		Corporate Director
Director of Clinical Informatics		 Dec 18, 2006
W-2 Managing Employee
Director of Clinical Informatics		 Dec 18, 2006
Amy Tovey
Individual 		Corporate Officer
Chief Operation Officer		 Jul 27, 2015
W-2 Managing Employee
Chief Operation Officer		 Jul 27, 2015
Adam Waldron
Individual 		Corporate Director
Board President		 Nov 5, 2011
Amanda Collins
Individual 		Corporate Director
Director of Outreach and Enrollment		 Mar 10, 2014
W-2 Managing Employee
Director of Outreach and Enrollment		 Mar 10, 2014
Gloria Whiteside
Individual 		Corporate Director
Board Member		 Sep 22, 2014
Leticia Palacios Ledesma
Individual 		W-2 Managing Employee
Ab & Af Team Lead		 Feb 22, 2010
Nancy Wright
Individual 		Corporate Director
Director of Executive Services		 Sep 28, 1994
W-2 Managing Employee
Director of Executive Services		 Sep 28, 1994
Hilary Humpherys
Individual 		Corporate Director
Director of Quality Improvement		 Feb 18, 2014
W-2 Managing Employee
Director of Quality Improvement		 Feb 18, 2014
Doug Balfour
Individual 		Corporate Director
Board Vice President		 Sep 22, 2014
Marcus Neff
Individual 		Corporate Director
Dental Director		 Jun 30, 2014
W-2 Managing Employee
Dental Director		 Jun 30, 2014
Daniel Davids
Individual 		Corporate Director
Board Member		 Jun 26, 2017
Mindy Stosich-Benedetti
Individual 		Corporate Officer
Chief Executive Officer		 May 15, 2006
W-2 Managing Employee
Chief Executive Officer		 May 15, 2006
Cheryl Reas
Individual 		W-2 Managing Employee
Controller		 Mar 10, 2015
Amber Davis
Individual 		Corporate Director
Board Member		 Jul 31, 2017

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Health West City Center
Pocatello, ID · CCN 131884		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 1, 1975
Indian Hills Elementary
Pocatello, ID · CCN 131887		 Federally qualified health center Operational/Managerial Control Apr 11, 2026

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031210000461 ID Part B Supplier - Clinic/Group Practice 4981500931 Receives reassigned benefits from 67 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aberdeen, ID; Preston, ID; Pocatello, ID; Montpelier, ID; Lava Hot Springs, ID; Downey, ID; Chubbuck, ID; American Falls, ID
O20140218001263 ID Part a Provider - Federally Qualified Health Center (FQHC) 4981500931 Practice locations: Chubbuck, ID

National Provider Directory

Part of
Health West Inc

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

880 W Quinn Rd
Chubbuck, ID 83202-2454

Mailing address

PO Box 2377
Pocatello, ID 83206-2377
Phone (208) 232-7862

Other names

  • Health West Chubbuck Clinic Doing business as

Other providers in Chubbuck, ID

All providers in Chubbuck, ID · Federally Qualified Health Center (FQHC) in Idaho

Sources for this page

Verify at the official NPI Registry.