Shoshone Medical Center

Primary specialty

Critical Access HospitalTaxonomy code 282NC0060X

Legal business name

SHOSHONE MEDICAL CENTER

Practice address

25 Jacobs Gulch Rd
Kellogg, ID 83837-2023

Phone

(208) 784-1228

Fax

(208) 786-1019

NPI assigned

Jul 12, 2022

Last updated

Jul 12, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

SHOSHONE MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

Kathy Tweedy

Title

Business Office Manager

Phone

(208) 784-1228

Specialties & licenses 1

Addresses

Tax ID family

West Shoshone Hosp Dist 12 organizations share this tax ID, including this one

Part of

West Shoshone Hosp Dist 1

Other organizations with this tax ID 1

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

• Shoshone Medical Center

  • Rural Health Clinic/Center
  • Smelterville, ID
  • NPI 1487272399
  NPD tax ID

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.

• Shoshone Medical Center

  • Critical Access Hospital
  • Kellogg, ID
  • NPI 1043215437
  NPPES parent name

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657584000000",
    "number": "1750015178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 JACOBS GULCH RD",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "838372023",
            "telephone_number": "208-784-1228",
            "fax_number": "208-786-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 JACOBS GULCH RD",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "838372023",
            "telephone_number": "208-784-1228",
            "fax_number": "208-786-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOSHONE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHOSHONE MEDICAL CENTER",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "TWEEDY",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "208-784-1228"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Denise Sepa-Newell, MA,ABS
• Sequel Alliance Family Services, LLC
• Tracci D Sevy, LMP
• Shoshone County EMS Corporation (Shoshone County EMS)
• Shoshone Medical Center
• Silver Valley Dietetic Care
• Silver Valley Emergency Physicians
• Silver Valley Family Practice PC
• Kathleen Sproles, LCSW
• Emma Stayduhar

• Critical Access Hospital in Kellogg, ID
• Providers in Kellogg, ID by specialty
• Critical Access Hospital in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.