NPIMap

Organization Active NPI

St. Benedicts Family Medical Center

  • Long Term Care Hospital
  • Jerome, ID
National Provider Identifier
1639211634
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
366HP Issued in ID
Legal business name
ST. BENEDICTS FAMILY MEDICAL CENTER
Practice address
709 N Lincoln Ave
Jerome, ID 83338-1851
Phone
(208) 324-4301
Fax
(208) 324-7815
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Bruce Alan Barnes, RPH
Title
Pharmacy Director
Phone
(208) 324-4301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X 366HP ID Primary

Addresses

Primary practice location

709 N Lincoln Ave
Jerome, ID 83338-1851

Mailing address

709 N Lincoln Ave
Jerome, ID 83338-1851
Phone (208) 324-4301

National Provider Directory

National Provider Directory
Tax ID family
Jerome Phys Evening Cli2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639211634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 N LINCOLN AVE",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833381851",
            "telephone_number": "208-324-4301",
            "fax_number": "208-324-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 N LINCOLN AVE",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833381851",
            "telephone_number": "208-324-4301",
            "fax_number": "208-324-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. BENEDICTS FAMILY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "208-324-4301",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "ID",
            "license": "366HP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jerome, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.