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Organization Active NPI

St Joseph Hospital LLC

Doing business as St. Joseph Regional Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Lewiston, ID
National Provider Identifier
1982553855
Registry record updated Jan 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ST JOSEPH HOSPITAL LLC
Doing business as
St. Joseph Regional Medical Group
Practice address
320 Warner Dr
Lewiston, ID 83501-4441
Phone
(208) 743-3523
Fax
(833) 941-3874
NPI assigned
Jan 24, 2026
Last updated
Jan 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2026

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

Authorized official

Name
Johnetta Traylor
Title
Administrator
Phone
(502) 596-6063

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

320 Warner Dr
Lewiston, ID 83501-4441

Mailing address

PO Box 94250
Seattle, WA 98124-6550
Phone (208) 750-7462

Other names 1

  • St. Joseph Regional Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260601000950 ID DME Supplier - Physician - Orthopedic/Orthopedic Surgery 8325325806 Practice locations: Lewiston, ID

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
St Joseph Hospital LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

320 Warner Dr
Lewiston, ID 83501
Phone (208) 298-1022

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
St Joseph Regional Medical CenterLewiston, ID, CCN 13T003 Hospital 5% Or Greater Indirect Ownership Interest Mar 17, 2025

Owned or controlled facilities with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1769212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769212800000",
    "number": "1982553855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94250",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981246550",
            "telephone_number": "208-750-7462",
            "fax_number": "208-750-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WARNER DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014441",
            "telephone_number": "208-743-3523",
            "fax_number": "833-941-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-24",
        "last_updated": "2026-01-24",
        "certification_date": "2026-01-24",
        "status": "A",
        "authorized_official_last_name": "TRAYLOR",
        "authorized_official_first_name": "JOHNETTA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "502-596-6063"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Joseph Regional Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.