Caribou Memorial Hospital

Primary specialty

Critical Access HospitalTaxonomy code 282NC0060X

License

37 Issued in ID

Legal business name

CARIBOU MEMORIAL HOSPITAL

Practice address

300 S 3Rd W
Soda Springs, ID 83276-1559

Phone

(208) 547-3341

Fax

(208) 547-2790

NPI assigned

Nov 3, 2005

Last updated

Aug 9, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

CARIBOU MEMORIAL HOSPITAL AND LIVING CENTERAs reported in NPPES

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

Authorized official

Name

John Hoopes

Title

Chief Executive Office

Phone

(208) 547-3341

Specialties & licenses 1

Addresses

Other identifiers 5

Part of

Caribou Memorial Hospital

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Caribou County

  dba Caribou County EMS

  • Land Ambulance
  • Soda Springs, ID
  • NPI 1982696449

  Member Of

  NPD member

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376006400000",
    "number": "1912998261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S 3RD W",
            "city": "SODA SPRINGS",
            "state": "ID",
            "postal_code": "832761559",
            "telephone_number": "208-547-3341",
            "fax_number": "208-547-2790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S 3RD W",
            "city": "SODA SPRINGS",
            "state": "ID",
            "postal_code": "832761559",
            "telephone_number": "208-547-3341",
            "fax_number": "208-547-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARIBOU MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARIBOU MEMORIAL HOSPITAL AND LIVING CENTER",
        "enumeration_date": "2005-11-03",
        "last_updated": "2013-08-09",
        "status": "A",
        "authorized_official_last_name": "HOOPES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICE",
        "authorized_official_telephone_number": "208-547-3341"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "ID",
            "license": "37",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "00042",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002863100",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002863500",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002863200",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PHYSICIAN",
            "identifier": "86934",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caribou Medical Center, Inc. (Caribou Medical Center Swing Bed)
• Caribou Medical Center, Inc. (Caribou Medical Center)
• Caribou Memorial Hospital
• Caribou Memorial Hospital
• Caribou Memorial Hospital
• Preston Boyd Christensen, MD
• Terry Lee Christensen, LMT
• Patricia Conner
• Douglas P. Cox, P.T.
• Eastman Drug Company Inc (Eastman Drug Store)

• Critical Access Hospital in Soda Springs, ID
• Providers in Soda Springs, ID by specialty
• Critical Access Hospital in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.