NPIMap

Organization Active NPI

Oneida County Hospital

  • Rural Health Clinic/Center
  • Malad City, ID
National Provider Identifier
1710041785
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
138509 Issued in ID
Legal business name
ONEIDA COUNTY HOSPITAL
Practice address
220 Bannock St
Malad City, ID 83252-1256
Phone
(208) 766-2600
Fax
(208) 766-4258
NPI assigned
Dec 21, 2006
Organization subpart
Yes
Parent organization
ONEIDA COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Authorized official

Name
Todd V Winder
Title
Administrator
Phone
(208) 766-2231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 138509 ID Primary

Addresses

Primary practice location

220 Bannock St
Malad City, ID 83252-1256

Mailing address

220 Bannock St
Malad City, ID 83252-1256
Phone (208) 766-2600

Other identifiers 1

IdentifierTypeStateIssuer
1265482905MedicaidID

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031211000830 ID Part B Supplier - Clinic/Group Practice 3476459108 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Malad City, ID
O20120109000377 ID Part A Provider - Rural Health Clinic 3476459108 Practice locations: Malad City, ID

Other NPIs with the same Medicare PAC ID 4

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

Rural health clinic certification: CCN 138509

Legal name
ONEIDA COUNTY HOSPITAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 23, 2006
Last certification
Aug 23, 2006
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
220 Bannock St
Malad City, ID 83252-5068
Related CCNs
131303

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

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
Part of
Oneida County Hospital Physicians Group

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Elaine Bohn Individual Corporate DirectorBoard Member Mar 23, 2006
Sandy Facer Individual Corporate DirectorBoard Member Jan 24, 2018
Oneida County Hospital Organization, Malad City, ID Operational/Managerial Control Jul 1, 2006 100%
Kim D Jenkins Individual Corporate DirectorBoard Member Aug 29, 2018
Cindy Howard Individual W-2 Managing EmployeeFinancial Services Director Jun 1, 1992 100%
Wendy Boyer Individual Corporate DirectorB Jan 27, 2018
County of Oneida Organization, Malad City, ID 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Krista Karn Individual Corporate DirectorBoard Member Sep 24, 2019
Shellee Daniels Individual Corporate DirectorBoard Member Jan 17, 2019
Cathie Jones Individual Corporate DirectorBoard Member Nov 2, 2017
John H Williams Individual Corporate DirectorCeo / Administrator Mar 22, 2013 100%
W-2 Managing EmployeeCeo / Administrator Mar 22, 2013 100%

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Nell J Redfield Memorial HospitalMalad City, ID, CCN 135062 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 1999
Jul 10, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1710041785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 BANNOCK ST",
            "city": "MALAD CITY",
            "state": "ID",
            "postal_code": "832521256",
            "telephone_number": "208-766-2600",
            "fax_number": "208-766-4258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 BANNOCK ST",
            "city": "MALAD CITY",
            "state": "ID",
            "postal_code": "832521256",
            "telephone_number": "208-766-2600",
            "fax_number": "208-766-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONEIDA COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ONEIDA COUNTY HOSPITAL",
        "enumeration_date": "2006-12-21",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "WINDER",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-766-2231"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "ID",
            "license": "138509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265482905",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malad City, ID

Sources for this page

Verify at the official NPI Registry.