NPIMap

Organization Active NPI

Steele Memorial Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Salmon, ID
National Provider Identifier
1992913479
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
28 Issued in ID
Legal business name
STEELE MEMORIAL MEDICAL CENTER
Practice address
203 S. Daisy St.
Salmon, ID 83467
Phone
(208) 756-5600
Fax
(208) 756-4169
NPI assigned
May 18, 2007
Last updated
Mar 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Authorized official

Name
Abner King
Title
Coo
Phone
(208) 756-5720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 28 ID Primary

Addresses

Primary practice location

203 S. Daisy St.
Salmon, ID 83467

Mailing address

203 S. Daisy St.
Salmon, ID 83467
Phone (208) 756-5600

Other identifiers 1

IdentifierTypeStateIssuer
002855100MedicaidID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071003000185 ID Part A Provider - Critical Access Hospital 9436131265 Practice locations: Salmon, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992913479. Details of each certification follow.

Hospital certification: CCN 13Z305

Legal name
STEELE MEMORIAL MEDICAL CENTER
Organization structure
OtherNon-profit
Enrollment address
203 S Daisy St
Salmon, ID 83467-4709
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Steele Memor Hosp Crna2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

811 Main St
Slamon, ID 83467
Phone (208) 756-4291

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Preston J Becker Individual Corporate OfficerCeo Jul 1, 2022 100%
W-2 Managing EmployeeAd; Jul 1, 2022 100%

Practitioners & affiliated clinicians

Practitioners 67

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.

View all 67

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395878400000",
    "number": "1992913479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S. DAISY ST.",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "83467",
            "telephone_number": "208-756-5600",
            "fax_number": "208-756-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S. DAISY ST.",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "83467",
            "telephone_number": "208-756-5600",
            "fax_number": "208-756-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEELE MEMORIAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2014-03-27",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "ABNER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "208-756-5720"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "ID",
            "license": "28",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002855100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salmon, ID

Sources for this page

Verify at the official NPI Registry.