NPIMap

Organization Active NPI

Southwest District Health

  • Public Health or Welfare Agency
  • Caldwell, ID
National Provider Identifier
1689820375
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
SOUTHWEST DISTRICT HEALTH
Practice address
13307 Miami LN
Caldwell, ID 83607-4701
Phone
(208) 455-5300
NPI assigned
Aug 13, 2008
Last updated
Jan 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Authorized official

Name
Bruce A Krosch
Title
Director
Phone
(208) 455-5300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

13307 Miami LN
Caldwell, ID 83607-4701

Mailing address

13307 Miami LN
Caldwell, ID 83607-4701
Phone (208) 455-5300

Other names 1

  • State of Idaho Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130403000376 ID Part B Supplier - Clinic/Group Practice 0143465666 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Caldwell, ID; Emmett, ID; Payette, ID; Weiser, ID

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357516800000",
    "number": "1689820375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13307 MIAMI LN",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836074701",
            "telephone_number": "208-455-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13307 MIAMI LN",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836074701",
            "telephone_number": "208-455-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST DISTRICT HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2013-01-07",
        "status": "A",
        "authorized_official_last_name": "KROSCH",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "208-455-5300"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "State of Idaho",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.