Organization
KOOTENAI HEALTH, INC.
Active
Other names
Kootenai Medical Center Group
Organization subpart
No
Provider details
NPI number
Authorized official
JON NESS (CEO)
(208) 625-5081
Entity
Organization
Contact information
Practice address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-4000
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-4000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
42
ID
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
42
ID
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
42
ID
208800000X
Urology Physician
42
ID
213E00000X
Podiatrist
42
ID
363A00000X
Physician Assistant
42
ID
363L00000X
Nurse Practitioner
42
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010004926
REGENCE BLUE SHIELD
ID
05
—
805712000
—
ID
01
—
83758
BLUE CROSS
ID
01
—
CG7380
RR MEDICARE
ID
Enumeration date
01/09/2007
Last updated
01/05/2024
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