NPIMap

Organization Active NPI

Bonner General Hospital, Inc

Doing business as Sandpoint Womens Health

  • Gynecology Physician
  • Sandpoint, ID
National Provider Identifier
1992069454
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
BONNER GENERAL HOSPITAL, INC
Doing business as
Sandpoint Womens Health
Practice address
423 N 3Rd Ave Ste 210
Sandpoint, ID 83864-1511
Phone
(208) 263-2173
Fax
(208) 263-7441
NPI assigned
Jun 29, 2012
Last updated
Sep 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Authorized official

Name
John Hennessy
Title
Ceo
Phone
(208) 265-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X NU Primary

Addresses

Primary practice location

423 N 3Rd Ave Ste 210
Sandpoint, ID 83864-1511

Mailing address

PO Box 1343
Sandpoint, ID 83864-0863
Phone (208) 265-1158

Other names 1

  • Sandpoint Womens Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040626000014 ID Part B Supplier - Clinic/Group Practice 4082690466 Receives reassigned benefits from 75 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sandpoint, ID

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
13D0522394Sandpoint Womens Health423 N Third Ave Ste 210, Sandpoint, ID 83864Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Bonner Professional Compounding9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Practitioners & affiliated clinicians

Practitioners 7

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": "1340928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790294400000",
    "number": "1992069454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1343",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838640863",
            "telephone_number": "208-265-1158",
            "fax_number": "208-265-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 N 3RD AVE STE 210",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641511",
            "telephone_number": "208-263-2173",
            "fax_number": "208-263-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNER GENERAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-29",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A",
        "authorized_official_last_name": "HENNESSY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-265-1100"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sandpoint Womens Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sandpoint Womens Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandpoint, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.