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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
Organization subpart
No

Authorized official

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

Other NPIs with the same Medicare PAC ID 2

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

Practitioners 65

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 65

Affiliated clinicians 5

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

Medicare participation

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

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.

Enrollment records 1

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

All disclosed owners & managing parties 1

Medicare enrollment files

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%

National Provider Directory

National Provider Directory
Tax ID family
Steele Memorial Hospital2 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

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

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

NPPES NPI Registry
IdentifierTypeStateIssuer
002855100MedicaidID

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 27, 2014.

{
    "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.