| Benewah Community Hospital | |
|
229 S 7th St St Maries ID 83861-1803 | |
| (208) 245-5551 | |
| (208) 245-5246 |
| Full Name | Benewah Community Hospital |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 229 S 7th St, St Maries, Idaho |
| Authorized Official Name and Position | Lori L Minier (CFO) |
| Authorized Official Contact | 2082457609 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Benewah Community Hospital 229 S 7th St St Maries ID 83861-1803 Ph: (208) 245-5551 | Benewah Community Hospital 229 S 7th St St Maries ID 83861-1803 Ph: (208) 245-5551 |
| NPI Number | 1548320435 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 01/02/2025 |
| Medicare PECOS PAC ID | 1850200700 |
|---|---|
| Medicare Enrollment ID | O20061104000136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548320435 | NPI | - | NPPES |
| Provider Name | Daniel Cooper Wester |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407965544 PECOS PAC ID: 6103718135 Enrollment ID: I20040406000608 |
| Provider Name | Albert J Martinez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114929833 PECOS PAC ID: 8729970942 Enrollment ID: I20040515000426 |
| Provider Name | David E Moody |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902808793 PECOS PAC ID: 1951392604 Enrollment ID: I20040520001259 |
| Provider Name | Casey J Fatz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306847488 PECOS PAC ID: 6901887678 Enrollment ID: I20040527001066 |
| Provider Name | Taylor F Reichel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841292620 PECOS PAC ID: 9830177427 Enrollment ID: I20040709001253 |
| Provider Name | Randon Lee Opp |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194727800 PECOS PAC ID: 6608766712 Enrollment ID: I20050103000646 |
| Provider Name | Bradley John Capawana |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1447257076 PECOS PAC ID: 7810976388 Enrollment ID: I20050411000883 |
| Provider Name | Brian Joseph Mcnamee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003818717 PECOS PAC ID: 5294762415 Enrollment ID: I20050720000079 |
| Provider Name | Lori T Rembe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275639577 PECOS PAC ID: 2264402122 Enrollment ID: I20060110000872 |
| Provider Name | Keith P Mcklendin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437139938 PECOS PAC ID: 0840245239 Enrollment ID: I20060809000521 |
| Provider Name | Twyla Jean Masterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366548661 PECOS PAC ID: 0648279521 Enrollment ID: I20061205000036 |
| Provider Name | Stephanie Marie Arar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316036189 PECOS PAC ID: 4587769187 Enrollment ID: I20070410000219 |
| Provider Name | Gary B Glenn |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962579797 PECOS PAC ID: 4183704091 Enrollment ID: I20080104000375 |
| Provider Name | Michael Lee Ettner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629061940 PECOS PAC ID: 1557496080 Enrollment ID: I20100322000917 |
| Provider Name | Wallace Eric Chun |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427041730 PECOS PAC ID: 3476680059 Enrollment ID: I20100430000292 |
| Provider Name | William Scott Spence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255351458 PECOS PAC ID: 7719966811 Enrollment ID: I20120612000136 |
| Provider Name | Bryan Douglas Berkey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114917606 PECOS PAC ID: 5890859227 Enrollment ID: I20120723000767 |
| Provider Name | William W Wheeler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205810025 PECOS PAC ID: 2668386228 Enrollment ID: I20120813000625 |
| Provider Name | Joshua Jacob Morris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619173143 PECOS PAC ID: 1557411485 Enrollment ID: I20121112000621 |
| Provider Name | Devin Traer Caywood |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962684571 PECOS PAC ID: 9032374400 Enrollment ID: I20130626000686 |
| Provider Name | Michael L Larsen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902005663 PECOS PAC ID: 2769559228 Enrollment ID: I20130723001013 |
| Provider Name | Luke Jonathan Grauke |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972751709 PECOS PAC ID: 9638333933 Enrollment ID: I20130920000188 |
| Provider Name | Marcus E Harrell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407959380 PECOS PAC ID: 8820197783 Enrollment ID: I20140711002268 |
| Provider Name | Richard Gary Watts |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023113545 PECOS PAC ID: 4789611732 Enrollment ID: I20150408002553 |
| Provider Name | Travis Aaron Newby |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669727665 PECOS PAC ID: 2961625785 Enrollment ID: I20150609000576 |
| Provider Name | Edward Gregory Moellmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942566195 PECOS PAC ID: 4486978079 Enrollment ID: I20160822000950 |
| Provider Name | Tim John Ochoa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609164417 PECOS PAC ID: 6608192158 Enrollment ID: I20160929002359 |
| Provider Name | Craig A Burns |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225472012 PECOS PAC ID: 5294055638 Enrollment ID: I20170712002265 |
| Provider Name | Philip John Dougherty |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750647913 PECOS PAC ID: 0446561716 Enrollment ID: I20180529002850 |
| Provider Name | Joshua R Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497011597 PECOS PAC ID: 9234368291 Enrollment ID: I20180702001691 |
| Provider Name | Frederick Paul Ragan |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1205092525 PECOS PAC ID: 3779651922 Enrollment ID: I20181214000304 |
| Provider Name | Kendall A Gunderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356992309 PECOS PAC ID: 1850725748 Enrollment ID: I20191231001716 |
| Provider Name | John Anthony Schirmer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023286424 PECOS PAC ID: 8921361874 Enrollment ID: I20200103001982 |
| Provider Name | Matthew S Lidstrom |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447512348 PECOS PAC ID: 3577871904 Enrollment ID: I20200401002280 |
| Provider Name | Derek A Khorsand |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598176448 PECOS PAC ID: 5092934398 Enrollment ID: I20200522002379 |
| Provider Name | James Lee Hug |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962015149 PECOS PAC ID: 7618395815 Enrollment ID: I20200921002230 |
| Provider Name | Patrick C Marvil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235629304 PECOS PAC ID: 7517369556 Enrollment ID: I20210816003765 |
| Provider Name | Jacob Pickering |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912240128 PECOS PAC ID: 5193084432 Enrollment ID: I20211016000019 |
| Provider Name | Mazen Zawaideh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356740930 PECOS PAC ID: 8820300775 Enrollment ID: I20211202000824 |
| Provider Name | Allyson Hudson Sterling |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861757676 PECOS PAC ID: 4082853940 Enrollment ID: I20220713004211 |
| Provider Name | Shahla F Syed |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730314030 PECOS PAC ID: 9032333836 Enrollment ID: I20230125001932 |
| Provider Name | Hannah Kathryn Bancroft |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033824784 PECOS PAC ID: 5193190569 Enrollment ID: I20230417002851 |
| Provider Name | Aaron Vincent Vizcarra |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1306253893 PECOS PAC ID: 1254557200 Enrollment ID: I20230915000628 |
| Provider Name | Jason Baltar Rodulfa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891102620 PECOS PAC ID: 1456694025 Enrollment ID: I20230919003407 |
| Provider Name | Jackson Joseph Bell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396208070 PECOS PAC ID: 9335470673 Enrollment ID: I20231018002055 |
| Provider Name | Kara Leigh Seigley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801672480 PECOS PAC ID: 4082060686 Enrollment ID: I20231101002857 |
| Provider Name | Coralyn Marie Furr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770730392 PECOS PAC ID: 4486711082 Enrollment ID: I20240423001848 |
| Provider Name | Cole E Ziegler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649776212 PECOS PAC ID: 0345596219 Enrollment ID: I20240531003578 |
| Provider Name | Patricia Ines Ojeda |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114375086 PECOS PAC ID: 3577855998 Enrollment ID: I20240611004210 |
| Provider Name | Donald Douglas Gandy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073552808 PECOS PAC ID: 7315907284 Enrollment ID: I20240705002103 |
| Provider Name | Dane W Jackson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952724361 PECOS PAC ID: 1951621887 Enrollment ID: I20240709001471 |
| Provider Name | Adrian T Davis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467618280 PECOS PAC ID: 6507171725 Enrollment ID: I20240801001829 |
| Provider Name | Joseph Benjamin Cooper |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063941383 PECOS PAC ID: 2163811654 Enrollment ID: I20240801002934 |
| Provider Name | Parker Lyons Quimby |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962060327 PECOS PAC ID: 3779900485 Enrollment ID: I20250122001208 |
| Provider Name | Michael Jaehoon Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356738207 PECOS PAC ID: 7618284639 Enrollment ID: I20250122001490 |
| Provider Name | Alejandro Santiago Toscano |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861874323 PECOS PAC ID: 4486934130 Enrollment ID: I20250506002704 |