Saint Alphonsus Regional Medical Center Inc
Organization Active NPI Family Medicine Physician · Caldwell, ID
NPI 1861676298 · NPPES record last updated Dec 30, 2025
Key facts
- NPI
- 1861676298
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC
- Practice address
- 712 Aviation Way
Caldwell, ID 83605-1154 - Phone
- (208) 302-1000
- Fax
- (208) 302-1035
- NPI assigned
- Dec 20, 2007
- Organization subpart
- No
Authorized official
- Name
- Brian Lannie Checketts
- Title
- Cfo
- Phone
- (208) 367-7347
Owners & managing parties with NPI records 1
Owned or controlled facilities with NPI records 3
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 3
Practitioners 865
-
Shawn Gillett Allen, P.A.
-
Justin Blaty, MD
-
Amber Bock, PAC
-
Bobby Chawla, D.O.
-
Lukas T Clark, MD
-
Patrick Scott Coleman, M.D.
-
Kendra Coonse, M.D.
-
Spencer John Craven, M.D.
-
Aaron Dunham, MD
-
Adam Stephen Grimaldi, M.D.
-
Yujean Han, D.O.
-
Savanah A Hawkins, PA-C
-
Jeffrey J Heslop, MD
-
Joshua David Holweger, M.D.
-
Jonelle Hudson, APRN-CNP
-
Petar G Igic, MD
-
Victor M Ishida, P.A.
-
Alex C Johnson, MD
-
William Kogler, DO
-
Jason E Kolb, PA-C
Affiliated clinicians 1,423
-
Candice Elaine Adams, DNP, APRN, AGPCNP-BC
-
Donald E Adams, MD
-
Joshua Allen Adams, M.D.
-
John T. Ader, DO-RHEUMATOLOGY
-
Luis Alcaraz, PA-C
-
Marc Allan, DO
-
Cameron Allen, DO
-
David Allen, CRNA
-
Ginger A. Allen, MD
-
Nicolas J. Allen, PA-C
-
Shawn Gillett Allen, P.A.
-
Suzanne M Allen, M.D.
-
Benjamin Andersen, DNP, FNP
-
Emily Dawn Anderson, AGNP
-
Noel Anderson, PA-C
-
Philip Anderson, DO
-
Riley Paige Anderson, PA-C
Medicare Care Compare: Hospital
- Listed as
- Saint Alphonsus Regional Medical Center
- Overall star rating
- ★★★☆☆ 3 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Church
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in ID, OR
Hospital certification: CCN 130007
- Legal name
- SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC
- Doing business as
- SAINT ALPHONSUS REGIONAL MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Sep 1, 2012
- Beds
- 365
- Ownership / control type
- Church
- Organization structure
- Corporation · Non-profit
- Incorporated
- Dec 2, 1958 in ID
- Enrollment address
- 1055 N Curtis Rd
Boise, ID 83706-1309 - Hospital subgroups
- General, Acute care
All disclosed owners & managing parties 19
| Name | Role | Since | Share |
|---|---|---|---|
| William Edward Avey |
Corporate Director |
Jan 1, 2026 | |
| Brian L Checketts |
Corporate Officer |
Dec 14, 2016 | |
| Operational/Managerial Control |
Dec 14, 2016 | ||
| Tonja Lee Nielsen |
Corporate Director |
Jan 2, 2022 | |
| Connie Russell Tanaka |
Corporate Director |
Jan 1, 2026 | |
| Saint Alphonsus Health System Inc |
5% Or Greater Indirect Ownership Interest | Apr 3, 2010 | 100% |
| Elsbeth Mulvaney |
Corporate Director |
Jan 1, 2026 | |
| Marie Guadalupe Wissel |
Corporate Director |
Jan 1, 2020 | |
| Michael Coughlin |
Corporate Director |
Jan 1, 2022 | |
| Jason D Wright |
Corporate Director |
Jan 1, 2026 | |
| David McFadyen |
Corporate Director |
Jul 20, 2020 | |
| Adam Richins |
Corporate Officer |
Jan 1, 2025 | |
| Corporate Director |
Jan 1, 2022 | ||
| Angela Faye Taylor |
Corporate Officer |
Jan 1, 2025 | |
| Corporate Director |
Jan 1, 2022 | ||
| Marcie Harper |
W-2 Managing Employee |
Jun 25, 2018 | |
| Operational/Managerial Control |
Jun 25, 2018 | ||
| Travis Leach |
Corporate Officer |
May 27, 2025 | |
| Corporate Director |
May 27, 2025 | ||
| Stephanie C Westermeier |
Corporate Officer |
Jan 20, 2010 | |
| Irma Roci Valdivia Barba |
Corporate Director |
Jan 1, 2025 | |
| Robert Ladenburger |
Corporate Director |
Jan 1, 2023 | |
| Trinity Health Corporation |
5% Or Greater Indirect Ownership Interest | May 1, 2000 | 100% |
| Michael Joseph Ballantyne |
Corporate Director |
Mar 6, 2020 |
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Saint Alphonsus Regional Rehabilitation Hospital, an Affiliate of Enco |
Hospital | 5% Or Greater Indirect Ownership Interest (49%) | Jan 29, 2018 |
| Enhabit Home Health & Hospice |
Home health agency | 5% Or Greater Direct Ownership Interest (50%) | Jun 30, 2014 |
| Enhabit Home Health & Hospice |
Hospice | 5% Or Greater Direct Ownership Interest (50%) | Jun 30, 2014 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030627000019 | ID | Part a Provider - Hospital | 3476462359 |
4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
| O20040204001036 | ID | Part B Supplier - Clinic/Group Practice | 3476462359 |
Receives reassigned benefits from 927 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
| O20130801000623 | OR | Part B Supplier - Clinic/Group Practice | 3476462359 |
Receives reassigned benefits from 57 practitioners Practice locations: Baker City, OR; Ontario, OR; La Grande, OR |
National Provider Directory
Locations
11035 W Karcher Rd
Nampa, ID 83651
Phone (208) 302-6600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X | |||
| Cardiovascular Disease Physician |
207RC0000X | |||
| Pulmonary Disease Physician |
207RP1001X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Pediatrics Physician |
208000000X | |||
| Neurology Physician |
2084N0400X | |||
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
208G00000X | |||
| Hospitalist Physician |
208M00000X | |||
| Pain Medicine Physician |
208VP0000X | |||
| Physician Assistant |
363A00000X | |||
| Surgical Physician Assistant |
363AS0400X | |||
| Nurse Practitioner |
363L00000X | |||
| Advanced Practice Midwife |
367A00000X |
Addresses
Primary practice location
712 Aviation Way
Caldwell, ID 83605-1154
Mailing address
1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-5170
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 806290700 | Medicaid | ID |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Caldwell, ID
- Saint Alphonsus Physician Services Inc
- Saint Alphonsus Physician Services Inc
- Saint Alphonsus Physician Services Inc
- Saint Alphonsus Regional Medical Center
- Saint Alphonsus Regional Medical Center Inc
- Jourdan Alexandra Salinas
- Saltzer Medical Group PA
- Julie Salvador
- Sana Kasumovic PLLC
- Donald E Sanford Jr.
All providers in Caldwell, ID · Family Medicine Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.