NPIMap

Organization Active NPI

Dirne Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Coeur D Alene, ID
National Provider Identifier
1689068413
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
DIRNE HEALTH CENTERS, INC
Practice address
2205 N Ironwood PL
Coeur D Alene, ID 83814-2610
Phone
(208) 783-1267
Fax
(844) 807-3782
NPI assigned
Mar 18, 2015
Organization subpart
Yes
Parent organization
DIRNE HEALTH CENTERS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Authorized official

Name
Mike Baker
Title
Ceo
Phone
(208) 620-5200

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

2205 N Ironwood PL
Coeur D Alene, ID 83814-2610

Mailing address

PO Box 1387
Hayden, ID 83835-1387
Phone (208) 620-5200

Other identifiers 1

IdentifierTypeStateIssuer
1378465OtherIDMEDICARE PART B

Other names 2

  • Heritage Health Homeless Program Doing business as
  • Street Medicine Community Outreach Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050303001041 ID Part B Supplier - Clinic/Group Practice 2466353354 Receives reassigned benefits from 86 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: St Maries, ID; Rathdrum, ID; Post Falls, ID; Kellogg, ID; Coeur D Alene, ID; Coeur D'Alene, ID
O20150925001389 ID Part A Provider - Federally Qualified Health Center (FQHC) 2466353354 Practice locations: Coeur D Alene, ID

Federally qualified health center certification: CCN 131867

Legal name
DIRNE HEALTH CENTERS, INC.
Doing business as
HERITAGE HEALTH HOMELESS PROGRAM
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 18, 2015
Last certification
Sep 18, 2015
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Jan 17, 1986 in ID
Enrollment address
2205 N Ironwood PL
Coeur D Alene, ID 83814-2610

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
Dirne Health Centers Inc10 organizations share this tax ID, including this one
Part of
Dirne Health Centers Inc

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Michael R Baker Individual Corporate OfficerCeo Dec 7, 2009
W-2 Managing EmployeeCeo Dec 7, 2009
Carl McMinimy Individual Corporate DirectorBoard Member Feb 24, 2025
Jana L Hull Individual Corporate DirectorBoard President Sep 27, 2016
Linda Johan Individual OtherBoard Secretary Feb 1, 2004
Paul Amador Individual Corporate DirectorBoard Member Feb 24, 2025
Brinnon Mandel Individual Corporate DirectorBoard Vice President Jan 1, 2015
Ann Spellman Dare Individual Corporate DirectorBoard Member Sep 27, 2016
Ron Beecher Individual Corporate DirectorBoard Member Jun 1, 2016
Ying Zhang Individual Corporate OfficerCfo Feb 24, 2025
Elizabeth Montgomery Individual Corporate DirectorBoard Member Feb 24, 2025
Pamela Sue Bellatty Thompson Individual Corporate DirectorBoard Member Feb 24, 2025
George Rohlinger Individual Corporate DirectorBoard Member Feb 24, 2025
Michael Schmidt Individual OtherBoard Member Nov 1, 2013
Bruce Cyr Individual Corporate DirectorBoard Member Feb 24, 2025

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1689068413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1387",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838351387",
            "telephone_number": "208-620-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 N IRONWOOD PL",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142610",
            "telephone_number": "208-783-1267",
            "fax_number": "844-807-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRNE HEALTH CENTERS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIRNE HEALTH CENTERS INC",
        "enumeration_date": "2015-03-18",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-620-5200"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "1378465",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Health Homeless Program",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Street Medicine Community Outreach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.