NPIMap

Organization Active NPI

St. Joseph Hospital, LLC

Doing business as St. Joseph Regional Medical Center

  • Rehabilitation Hospital Unit
  • Lewiston, ID
National Provider Identifier
1629783295
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
ST. JOSEPH HOSPITAL, LLC
Doing business as
St. Joseph Regional Medical Center
Practice address
415 6TH St
Lewiston, ID 83501-2431
Phone
(208) 743-2511
NPI assigned
Jan 18, 2023
Last updated
Jun 10, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. JOSEPH HOSPITAL, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Authorized official

Name
Johnetta Traylor, PESC
Title
Director
Phone
(502) 596-6063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X NU Primary

Addresses

Primary practice location

415 6TH St
Lewiston, ID 83501-2431

Mailing address

680 S 4TH St
Louisville, KY 40202-2407
Phone (502) 596-7300

Other names 1

  • St. Joseph Regional Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230629002677 ID Part A Provider - Hospital 8325325806 Practice locations: Lewiston, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629783295. Details of each certification follow.

Hospital certification: CCN 13T003

Legal name
ST JOSEPH HOSPITAL LLC
Doing business as
ST JOSEPH REGIONAL MEDICAL CENTER
Organization structure
LLCProprietary
Enrollment address
415 6TH St
Lewiston, ID 83501-2431
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
St Joseph Regional Medical CenterCCN 13T003 · All quality measures
Ownership
Non-profit
Certified
Feb 9, 2024

National Provider Directory

National Provider Directory
Tax ID family
St Joseph Hospital LLC7 organizations share this tax ID, including this one
Part of
St Joseph Hospital LLC

Other organizations with this tax ID 6

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

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Kindred Healthcare Operating LLC Organization, Louisville, KY LLC, Management services company, For-profit Operational/Managerial Control Dec 23, 2021 100%
Scott Graeser Individual Corporate OfficerVice President, Treasurer Aug 19, 2022
St Joseph Holdings LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Direct Ownership Interest May 1, 2017 100%
Dana M Rock Individual Corporate OfficerAssistant Administrator Dec 9, 2024
Johnetta M Traylor Individual Corporate OfficerAdministrator Dec 9, 2024
W-2 Managing EmployeeAd; Dec 9, 2024
Russell Pigg Individual Corporate OfficerCfo Mar 17, 2025
Knight Health Holdings LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2021 100%
Michael Joseph Bean Individual Corporate OfficerVice President, Tax Jan 21, 2022
Knight Healthcare New-B, LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
St Joseph Hospital LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Indirect Ownership Interest Mar 17, 2025
Knight Health II, LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Alan Wenk Individual Corporate OfficerCfo Mar 17, 2025

Owners & managing parties with NPI records 5

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

Facilities with the same owner 97

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • St. Joseph Hospital LLC

    dba St. Joseph Regional Medical Center

    • General Acute Care Hospital
    • Lewiston, ID
    • NPI 1225090954

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Health II, LLC, Knight Healthcare New-B, LLC, St Joseph Holdings LLC

    CMS ownership
  • St. Joseph Hospital, LLC
    • Psychiatric Hospital Unit
    • Lewiston, ID
    • NPI 1205975851

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Health II, LLC, Knight Healthcare New-B, LLC, St Joseph Holdings LLC

    CMS ownership
  • Andalusia Physician Practices LLC

    dba Andalusia Family Healthcare

    • Rural Health Clinic/Center
    • Andalusia, AL
    • NPI 1417663576

    Knight Health Holdings LLC, Knight Health II, LLC

    CMS ownership
  • CHG Hospital Austin, LLC

    dba Cornerstone Specialty Hospitals Round Rock

    • Rehabilitation Hospital Unit
    • Round Rock, TX
    • NPI 1396326948

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
  • CHG Hospital Austin, LLC

    dba Cornerstone Specialty Hospitals Round Rock

    • Long Term Care Hospital
    • Round Rock, TX
    • NPI 1912395203

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
  • CHG Hospital Conroe, LLC

    dba Cornerstone Specialty Hospitals Conroe

    • Long Term Care Hospital
    • Conroe, TX
    • NPI 1073901476

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
  • CHG Hospital Little Rock, LLC

    dba Cornerstone Specialty Hospitals Little Rock

    • Long Term Care Hospital
    • Little Rock, AR
    • NPI 1346630589

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
  • CHG Hospital McAllen, LLC

    dba Solara Specialty Hospitals McAllen

    • Long Term Care Hospital
    • McAllen, TX
    • NPI 1760870166

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
  • Community Hospital of Andalusia LLC

    dba Andalusia Health

    • General Acute Care Hospital
    • Andalusia, AL
    • NPI 1821078494

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Health II, LLC

    CMS ownership
  • Cornerstone Hospital of Huntington, LLC

    dba Cornerstone Specialty Hospitals Huntington

    • Long Term Care Hospital
    • Huntington, WV
    • NPI 1548214786

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
  • Dallas Ltach, LLC

    dba Kindred Hospital Dallas Central

    • Long Term Care Hospital
    • Dallas, TX
    • NPI 1356559991

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
  • Dallas Ltach, LLC

    dba Kindred Hospital Dallas Central (Acute Rehab Unit)

    • Rehabilitation Hospital Unit
    • Dallas, TX
    • NPI 1821741539

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
View all 97

Practitioners & affiliated clinicians

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1629783295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407",
            "telephone_number": "502-596-7300",
            "fax_number": "502-212-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 6TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012431",
            "telephone_number": "208-743-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH HOSPITAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. JOSEPH HOSPITAL, LLC",
        "enumeration_date": "2023-01-18",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "TRAYLOR",
        "authorized_official_first_name": "JOHNETTA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "502-596-6063",
        "authorized_official_credential": "PESC"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Joseph Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Joseph Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.