Clearwater Valley Hospital & Clinics Inc.
Organization Active NPI Family Medicine Physician · Orofino, ID
NPI 1891733747 · NPPES record last updated Aug 10, 2026
Key facts
- NPI
- 1891733747
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CLEARWATER VALLEY HOSPITAL & CLINICS INC.
- Practice address
- 301 Cedar St
Orofino, ID 83544-9029 - Phone
- (208) 476-4555
- Fax
- (208) 476-5385
- NPI assigned
- Jun 3, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- KOOTENAI HEALTH, INC.
Authorized official
- Name
- Lenne Bonner
- Title
- Ceo
- Phone
- (208) 476-8008
Owners & managing parties with NPI records 4
-
Kelly McGrath, MD
Other NPIs on the same Medicare enrollment 4
Related certifications (CCN) 2
Practitioners 57
-
Jane A Fore, MD
-
Jacob R Foster, PA-C
-
Anna Fox, MD
-
Suzanne Rose Kangas, PA-C
-
Andrea Krogh, PA-C
-
Kevin Lienesch, DNP, CRNA
-
Ann Lima, MD
-
Ally Loveland, DO
-
John Seth Lukens, MD
-
Kelly McGrath, MD
-
Travis Pehrson, APRN-CNP
-
Karin Schmidova, MD
-
Nicole Walls, FNP-BC
-
Phebe Lore Alley, MD
-
Giancarlo Colon Vilar, M.D.
Affiliated clinicians 111
-
Abeer Arain, M.D., M.P.H
-
Briana Sarah Bowden, ANP
-
Joseph Marshall Bowen, M.D.
-
Wendi Rene Boyer, CRNA MNA
-
Vanessa Kimberly Brown, M.D.
-
Tyler Howard Buckley, M.D.
-
Jeffrey Daniel Burry, D.O.
-
Kimberly Jordan Campbell, M.D.
-
Stephanie Margaret Carpenter, PMHNP-C
-
Aaron J Chalmers, M.D.
-
Erik F Cooper, CNP
-
Laurel Cope, PA-C
-
Charles Qiming Cui, M.D.
-
Michele Renee Dickison, NP-C
-
Dean Easton, M.D.
-
Donald Franklin Engles, M.D.
-
Robert Kenneth Fairbanks, M.D.
Medicare Care Compare: Hospital
- Listed as
- Clearwater Valley Hospital & Clinics
- Overall star rating
- ★★☆☆☆ 2 of 5
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ID
Hospital certification: CCN 131320
- Legal name
- CLEARWATER VALLEY HOSPITAL & CLINICS
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Feb 1, 2003
- Last certification
- Dec 11, 2020
- Beds
- 23
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 301 Cedar St
Orofino, ID 83544-9029
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Cynthia O'Brien |
Corporate Director |
Apr 1, 2020 | |
| Lenne J Bonner |
Corporate Officer |
Oct 29, 2007 | |
| W-2 Managing Employee |
Oct 29, 2007 | ||
| Rene Forsman |
Corporate Director |
Apr 1, 2020 | |
| Jon Ness |
Other |
Apr 1, 2020 | |
| Leonard Hill |
Corporate Director |
Apr 1, 2020 | |
| Matt Sartini |
Corporate Director |
Apr 1, 2020 | |
| Barbara Jean Glodowski |
Corporate Director |
Apr 1, 2020 | |
| Lisa Maurer |
Corporate Director |
Apr 1, 2020 | |
| Christina Ulmer |
Corporate Director |
Apr 1, 2020 | |
| Clarence J Brunson |
Corporate Director |
Apr 1, 2020 | |
| Kootenai Health, Inc. |
5% Or Greater Direct Ownership Interest | Apr 1, 2020 | 100% |
| Jeremy Evans |
Corporate Director |
Apr 1, 2020 | |
| Kimberly Ingram |
Corporate Director |
Apr 1, 2020 | |
| Kelly J McGrath |
Corporate Director |
Apr 1, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031117000264 | ID | Part B Supplier - Clinic/Group Practice | 0547173346 |
Receives reassigned benefits from 92 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Orofino, ID |
| O20061104000428 | ID | Part a Provider - Critical Access Hospital | 0547173346 |
Receives reassigned benefits from 81 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Orofino, ID |
National Provider Directory
Locations
1919 Lincoln Way
Ste 319
Coeur D Alene, ID 83814
320 N Division Ave
Craigmont, ID 83523
Phone (208) 924-5504
201 Thenon St
Kooskia, ID 83539
Phone (208) 926-7801
501 Oak St
Nezperce, ID 83543
Phone (208) 937-2496
Interoperability endpoints
- rebeccakatzman@cvhsmh.medalliesdirect.net
- suzannekangas@cvhsmh.medalliesdirect.net
- allyloveland@cvhsmh.medalliesdirect.net
- vanessabrown@cvhsmh.medalliesdirect.net
- markackerman@cvhsmh.medalliesdirect.net
- jakefoster@cvhsmh.medalliesdirect.net
- janefore@cvhsmh.medalliesdirect.net
- colleensholar@cvhsmh.medalliesdirect.net
- tammymiller@cvhsmh.medalliesdirect.net
- shellyfrayser@cvhsmh.medalliesdirect.net
- kellymcgrath@cvhsmh.medalliesdirect.net
- charityrobinson@cvhsmh.medalliesdirect.net
- phebealley@cvhsmh.medalliesdirect.net
- nicolewalls@cvhsmh.medalliesdirect.net
- annlima@cvhsmh.medalliesdirect.net
- annafox@cvhsmh.medalliesdirect.net
- karinschmidova@cvhsmh.medalliesdirect.net
- lauranoyes@cvhsmh.medalliesdirect.net
- sethlukens@cvhsmh.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Physician Assistant |
363A00000X |
Addresses
Primary practice location
301 Cedar St
Orofino, ID 83544-9029
Mailing address
201 Thenon St
Kooskia, ID 83539-6010
Phone (208) 926-7801
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 805060900 | Medicaid | ID |
Other names
- Kooskia Medical Clinic
Other providers in Orofino, ID
- Clearwater Valley Hospital & Clinics Inc.
- Clearwater Valley Hospital & Clinics Inc.
- Clearwater Valley Hospital & Clinics Inc.
- Clearwater Valley Hospital & Clinics Inc.
- Clearwater Valley Hospital & Clinics Inc.
- Clearwater Valley Hospital & Clinics Inc.
- Rana Janine Cleary
- Nicole Cleveland
- Tammy Jo Cochrane
- Compcare Inc
All providers in Orofino, 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 Aug 10, 2026. 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.