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Organization Active NPI

Syringa General Hospital District C I F

  • Critical Access Hospital
  • Grangeville, ID
National Provider Identifier
1750336608
Registry record updated Jul 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
18 Issued in ID
Legal business name
SYRINGA GENERAL HOSPITAL DISTRICT C I F
Practice address
607 W Main St
Grangeville, ID 83530-1345
Phone
(208) 983-1700
NPI assigned
May 22, 2006
Last updated
Jul 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2024

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

Authorized official

Name
David Paul Applewood
Title
Chief Financial Officer
Phone
(208) 983-1700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 18 ID Primary
Land Ambulance 3416L0300X 7208 ID

Addresses

Primary practice location

607 W Main St
Grangeville, ID 83530-1345

Mailing address

607 W Main St
Grangeville, ID 83530-1345
Phone (208) 983-1700

Other identifiers 4

IdentifierTypeStateIssuer
00299OtherIDBLUE CROSS OF IDAHO
83642OtherIDPRO FEE BLUE CROSS OF ID
000010006515OtherIDREGENCE BLUE SHIELD OF ID
002438100MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20041008000778 ID Part B Supplier - Clinic/Group Practice 6800707530 Receives reassigned benefits from 31 practitioners
Practice locations: Grangeville, ID
O20061104000551 ID Part A Provider - Critical Access Hospital 6800707530 Receives reassigned benefits from 31 practitioners
Practice locations: Grangeville, ID
O20071002000497 ID Part A Provider - Critical Access Hospital 6800707530 Practice locations: Grangeville, ID

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1750336608. Details of each certification follow.

Hospital certification: CCN 131315

Legal name
SYRINGA GENERAL HOSPITAL DISTRICT C I F
Doing business as
SYRINGA GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Feb 1, 2001
Last certification
Mar 13, 2025
Beds
16
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Enrollment address
607 W Main St
Grangeville, ID 83530-1345
Other Hospital Practice Location

Hospital certification: CCN 13Z315

Legal name
SYRINGA GENERAL HOSPITAL DISTRICT C I F
Doing business as
SYRINGA GENERAL HOSPITAL
Organization structure
OtherNon-profit
Enrollment address
607 W Main St
Grangeville, ID 83530-1345
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Syringa General HospitalCCN 131315 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in 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
Charlene Boyer Individual W-2 Managing EmployeeCeo Mar 2, 2026
Randall J Nightengale Individual W-2 Managing EmployeeCfo Apr 9, 2026
David E McKnight Individual Corporate Director Jun 24, 2025
Corporate DirectorBoard of Directors Jun 24, 2025
James J Paradiso Individual Corporate Director Jun 24, 2025
Corporate DirectorBoard of Directors Jun 24, 2025
Logan Staples Individual Corporate Director Feb 25, 2025
Corporate DirectorBoard of Directors Feb 25, 2025
Gunther M Williams Individual Corporate Director Jun 25, 2025
Corporate DirectorBoard of Directors Jun 24, 2025
Terri Tackett Individual Corporate DirectorBoard of Directors Jun 25, 2024
Jane M Carlson Individual Corporate DirectorBoard Member May 30, 2017
Corporate DirectorBoard of Directors Sep 1, 2017
Syringa General Hospital District C I F Organization, Grangeville, ID 5% Or Greater Direct Ownership Interest Nov 5, 2007 100%
5% Or Greater Direct Ownership Interest Jul 1, 1975 100%
Gerald W Zumwalt Individual Corporate DirectorBoard Member May 30, 2017
Corporate DirectorBoard of Directors Sep 1, 2017
Laura Smith Individual Corporate DirectorBoard Member Jun 25, 2019
Corporate DirectorBoard of Directors Jun 1, 2019

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Syringa General Hospital HospiceGrangeville, ID, CCN 131534 Hospice Operational/Managerial Control Jan 1, 2018
Syringa Hospital & ClinicsGrangeville, ID, CCN 138517 Rural health clinic Operational/Managerial Control Jan 1, 2018
Syringa Hospital & ClinicsKooskia, ID, CCN 138518 Rural health clinic Operational/Managerial Control Jan 1, 2018

Owned or controlled facilities with NPI records 3

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.

Practitioners & affiliated clinicians

Practitioners 33

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 33

Affiliated clinicians 74

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720828800000",
    "number": "1750336608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 W MAIN ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835301345",
            "telephone_number": "208-983-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 W MAIN ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835301345",
            "telephone_number": "208-983-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYRINGA GENERAL HOSPITAL DISTRICT C I F",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2024-07-13",
        "certification_date": "2024-07-13",
        "status": "A",
        "authorized_official_last_name": "APPLEWOOD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "208-983-1700"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "ID",
            "license": "18",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ID",
            "license": "7208",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "00299",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRO FEE BLUE CROSS OF ID",
            "identifier": "83642",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010006515",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002438100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grangeville, ID

Sources for this page

Verify at the official NPI Registry.