NPIMap

Organization Active NPI

McCall Memorial Hospital

  • Medical Physician Assistant
  • McCall, ID
National Provider Identifier
1790846392
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
11 Issued in ID
Legal business name
MCCALL MEMORIAL HOSPITAL
Practice address
1000 State St
McCall, ID 83638-3704
Phone
(208) 634-2221
Fax
(208) 634-7112
NPI assigned
Dec 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Karen J Kellie
Title
President Administrator
Phone
(208) 634-2221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 11 ID Primary

Addresses

Primary practice location

1000 State St
McCall, ID 83638-3704

Mailing address

1000 State St
McCall, ID 83638-3704
Phone (208) 634-2221

Other names 1

  • Mid Level Practitioner Group Other name

National Provider Directory

National Provider Directory
Tax ID family
McCall Memorial Hosp DME4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790846392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 STATE ST",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836383704",
            "telephone_number": "208-634-2221",
            "fax_number": "208-634-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 STATE ST",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836383704",
            "telephone_number": "208-634-2221",
            "fax_number": "208-634-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCALL MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLIE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT ADMINISTRATOR",
        "authorized_official_telephone_number": "208-634-2221",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "11",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid Level Practitioner Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in McCall, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.