Active NPI
Oneida County Hospital
- Rural Health Clinic/Center
- Malad City, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- License
- 138509
- 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
- Last updated
- Mar 14, 2008
- Organization subpart
- Yes
- Parent organization
- ONEIDA COUNTY HOSPITAL
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1710041785. Details of each certification follow.
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
- Other
- Enrollment address
- 220 Bannock St
Malad City, ID 83252-5068 - Related CCNs
- 131303
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
Other NPIs with the same Medicare PAC ID 4
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Rural Health Clinic
- Rural Health Clinic/Center
- Malad City, ID
- NPI 1225276454
3476459108
-
dba Oneida County Hospital Long Term Care
- Skilled Nursing Facility
- Malad, ID
- NPI 1811949431
3476459108
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Rural Health Clinic
- Rural Health Clinic/Center
- Malad City, ID
- NPI 1225276454
O20031211000830
National Provider Directory
National Provider Directory- Part of
- Malad Valley Clinic
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Elaine Bohn | Corporate Director | Mar 23, 2006 | |
| Sandy Facer | Corporate Director | Jan 24, 2018 | |
| Oneida County Hospital | Operational/Managerial Control | Jul 1, 2006 | 100% |
| Kim D Jenkins | Corporate Director | Aug 29, 2018 | |
| Cindy Howard | W-2 Managing Employee | Jun 1, 1992 | 100% |
| Wendy Boyer | Corporate Director | Jan 27, 2018 | |
| County of Oneida | 5% Or Greater Direct Ownership Interest | Jan 1, 1966 | 100% |
| Krista Karn | Corporate Director | Sep 24, 2019 | |
| Shellee Daniels | Corporate Director | Jan 17, 2019 | |
| Cathie Jones | Corporate Director | Nov 2, 2017 | |
| John H Williams | Corporate Director | Mar 22, 2013 | 100% |
| W-2 Managing Employee | 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.
-
- Land Ambulance
- Malad City, ID
- NPI 1770788929
5% Or Greater Direct Ownership Interest
-
dba Rural Health Clinic
- Rural Health Clinic/Center
- Malad City, ID
- NPI 1225276454
Operational/Managerial Control
-
- Medicare Defined Swing Bed Hospital Unit
- Malad, ID
- NPI 1568414167
Operational/Managerial Control
-
- Critical Access Hospital
- Malad, ID
- NPI 1609826270
Operational/Managerial Control
-
dba Oneida County Hospital Long Term Care
- Skilled Nursing Facility
- Malad, ID
- NPI 1811949431
Operational/Managerial Control
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Nell J Redfield Memorial Hospital | 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.
-
dba Oneida County Hospital Long Term Care
- Skilled Nursing Facility
- Malad, ID
- NPI 1811949431
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 3
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Medicare Defined Swing Bed Hospital Unit
- Malad, ID
- NPI 1568414167
County of Oneida
-
dba Oneida County Hospital Long Term Care
- Skilled Nursing Facility
- Malad, ID
- NPI 1811949431
County of Oneida, Oneida County Hospital
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.
-
- Critical Access Hospital
- Malad, ID
- NPI 1609826270
Practitioners & affiliated clinicians
Practitioners 16
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.
-
- Family Medicine Physician
- Malad City, ID
- NPI 1265424741
-
- Physician Assistant
- Malad City, ID
- NPI 1033190533
-
- Clinical Social Worker
- Malad City, ID
- NPI 1487189163
-
- Family Nurse Practitioner
- Malad City, ID
- NPI 1639283302
-
- Family Medicine Physician
- Malad City, ID
- NPI 1265482905
-
- Nurse Practitioner
- Malad City, ID
- NPI 1467685511
-
- Family Nurse Practitioner
- Malad City, ID
- NPI 1922725746
-
- Family Medicine Physician
- Malad City, ID
- NPI 1275735045
-
- Family Medicine Physician
- Malad City, ID
- NPI 1821034562
-
- Family Medicine Physician
- Malad, ID
- NPI 1003179706
-
- Otolaryngology Physician
- Ogden, UT
- NPI 1588651152
-
- Medical Physician Assistant
- Providence, UT
- NPI 1164176772
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": [],
"endpoints": [],
"other_names": []
}
Other providers in Malad City, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.