NPIMap

Organization Active NPI

Cascade Medical Center Hospital District

Doing business as Cascade Medical Center Donnelly Clinic

  • Rural Health Clinic/Center
  • Donnelly, ID
National Provider Identifier
1821864877
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CASCADE MEDICAL CENTER HOSPITAL DISTRICT
Doing business as
Cascade Medical Center Donnelly Clinic
Practice address
454 W Roseberry Road
Suite 103
Donnelly, ID 83615
Phone
(208) 382-4285
Fax
(208) 382-5081
NPI assigned
Nov 30, 2023
Last updated
Feb 11, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CASCADE MEDICAL CENTER HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Authorized official

Name
Sarah Hasbrouck
Title
Business Office Manager
Phone
(208) 408-5025

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

454 W Roseberry Road
Suite 103
Donnelly, ID 83615

Mailing address

PO Box 1330
Cascade, ID 83611-1330

Other names 1

  • Cascade Medical Center Donnelly Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240226000522 ID Part A Provider - Rural Health Clinic 6103739719 Practice locations: Donnelly, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821864877. Details of each certification follow.

Rural health clinic certification: CCN 138537

Legal name
CASCADE MEDICAL CENTER HOSPITAL DISTRICT
Doing business as
CASCADE MEDICAL CENTER DONNELLY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 4, 2024
Last certification
Sep 4, 2024
Ownership / control type
2A
Organization structure
OtherNon-profit
Incorporated
Jun 1, 2000 in ID
Enrollment address
454 W Roseberry Rd
Suite 103
Donnelly, ID 83615
Related CCNs
131308

Other NPIs with the same Medicare PAC ID 2

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2296283Cascade Medical Center Donnelly Clinic454 W Roseberry Rd #103, Donnelly, ID 83615Certificate of waiverDec 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Gregory McKim MD4 organizations share this tax ID, including this one
Part of
Gregory McKim MD

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the 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 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Thomas Allan Reinhardt Individual Corporate OfficerCeo Nov 26, 2018
Sarah Hasbrouck Individual W-2 Managing Employee Apr 16, 2018
Cascade Medical Center Hospital District Organization, Cascade, ID Operational/Managerial Control Mar 1, 2024 100%

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Cascade Medical Center Hospital DistrictCascade, ID, CCN 130779 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 12, 1984
Cascade Family PracticeCascade, ID, CCN 133993 Rural health clinic Other (100%) Sep 20, 1995

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 6

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": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1821864877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1330",
            "city": "CASCADE",
            "state": "ID",
            "postal_code": "836111330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 W ROSEBERRY ROAD",
            "address_2": "SUITE 103",
            "city": "DONNELLY",
            "state": "ID",
            "postal_code": "83615",
            "telephone_number": "208-382-4285",
            "fax_number": "208-382-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE MEDICAL CENTER HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CASCADE MEDICAL CENTER HOSPITAL DISTRICT",
        "enumeration_date": "2023-11-30",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "HASBROUCK",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "208-408-5025"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cascade Medical Center Donnelly Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cascade Medical Center Donnelly Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Donnelly, ID

Sources for this page

Verify at the official NPI Registry.