NPIMap

Organization Active NPI

St. Mary's Hospital Inc

Doing business as St. Mary's Grangeville Clinic

  • Family Medicine Physician
  • Grangeville, ID
National Provider Identifier
1710203237
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST. MARY'S HOSPITAL INC
Doing business as
St. Mary's Grangeville Clinic
St. Mary's Health
Practice address
617 W North St
Grangeville, ID 83530-1239
Phone
(208) 962-3267
Fax
(208) 962-2313
NPI assigned
Apr 8, 2010
Last updated
Aug 10, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
KOOTENAI HEALTH, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

Name
Lenne Bonner
Title
Ceo
Phone
(208) 476-8008

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ID
Family Medicine Physician 207Q00000X ID Primary

Addresses

Primary practice location

617 W North St
Grangeville, ID 83530-1239

Mailing address

617 W North St
Grangeville, ID 83530-1239
Phone (208) 962-3267

Other names 2

  • St. Mary's Grangeville Clinic Doing business as
  • St. Mary's Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050316000814 ID Part B Supplier - Clinic/Group Practice 5092773168 Receives reassigned benefits from 98 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cottonwood, ID; Craigmont, ID; Grangeville, ID; Kamiah, ID; Nezperce, ID

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
St Mary's Hospital Crna14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1710203237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 W NORTH ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835301239",
            "telephone_number": "208-962-3267",
            "fax_number": "208-962-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 W NORTH ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835301239",
            "telephone_number": "208-962-3267",
            "fax_number": "208-962-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOOTENAI HEALTH, INC.",
        "enumeration_date": "2010-04-08",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "BONNER",
        "authorized_official_first_name": "LENNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-476-8008"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Mary's Grangeville Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Mary's Grangeville Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Mary's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grangeville, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.