Active NPI
Nez Perce Tribal Health Authority
Doing business as (DBA) Nimiipuu Health
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Lapwai, ID
National Provider Identifier
1790795888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Legal business name
- NEZ PERCE TRIBAL HEALTH AUTHORITY
- Doing business as
- (DBA) Nimiipuu Health
- Practice address
- 111 Bever Grade
Nimiipuu Health
Lapwai, ID 83540-0367 - Phone
- (208) 843-2271
- Fax
- (208) 621-4995
- NPI assigned
- Aug 9, 2006
- Last updated
- Jul 22, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- R. Kim Hartwig, MD
- Title
- Medical Director
- Phone
- (208) 843-2271
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | ID | ||
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X | NU | Primary |
Addresses
Primary practice location
111 Bever Grade
Nimiipuu Health
Lapwai, ID 83540-0367
Mailing address
PO Box 367
Lapwai, ID 83540-0367
Phone (208) 843-2271
Other practice location 1
313 3rd Street
Kamiah, ID 83536
Phone (208) 935-0733
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 805010102 | Medicaid | ID | |
| 805010100 | Medicaid | ID |
Other names 1
- (DBA) Nimiipuu Health
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
123 W 3rd St
Kamiah, ID 83536
Phone (208) 843-2221
313 3Rd St
Kamiah, ID 83536
Phone (208) 843-2271
313 3Rd St
Nimiipuu Health
Kamiah, ID 83536
Phone (208) 621-4946
313 3Rd St
Nimiipuu Health
Kamiah, ID 83536
Phone (208) 935-0733
Practitioners & affiliated clinicians
Practitioners 30
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658448000000",
"number": "1790795888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 367",
"city": "LAPWAI",
"state": "ID",
"postal_code": "835400367",
"telephone_number": "208-843-2271",
"fax_number": "208-621-4995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 BEVER GRADE",
"address_2": "NIMIIPUU HEALTH",
"city": "LAPWAI",
"state": "ID",
"postal_code": "835400367",
"telephone_number": "208-843-2271",
"fax_number": "208-621-4995"
}
],
"practiceLocations": [
{
"address_1": "313 3rd Street",
"address_purpose": "LOCATION",
"city": "Kamiah",
"state": "ID",
"postal_code": "83536",
"country_code": "US",
"telephone_number": "208-935-0733",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "NEZ PERCE TRIBAL HEALTH AUTHORITY",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-09",
"last_updated": "2022-07-22",
"certification_date": "2022-07-13",
"status": "A",
"authorized_official_last_name": "HARTWIG",
"authorized_official_first_name": "R.",
"authorized_official_middle_name": "KIM",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "208-843-2271",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "ID",
"license": null,
"primary": false
},
{
"code": "332800000X",
"taxonomy_group": "",
"desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805010102",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805010100",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "(DBA) Nimiipuu Health",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "(DBA) Nimiipuu Health",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lapwai, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.