| Cascade Medical Center Hospital District | |
|
402 Lake Cascade Pkwy Cascade ID 83611-7702 | |
| (208) 382-4242 | |
| Not Available |
| Full Name | Cascade Medical Center Hospital District |
|---|---|
| Speciality | Clinic/Center |
| Location | 402 Lake Cascade Pkwy, Cascade, Idaho |
| Authorized Official Name and Position | Sarah Hasbrouck (BUSINESS OFFICE MANAGER) |
| Authorized Official Contact | 2084085025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cascade Medical Center Hospital District Po Box 1330 Cascade ID 83611-1330 Ph: (208) 382-4242 | Cascade Medical Center Hospital District 402 Lake Cascade Pkwy Cascade ID 83611-7702 Ph: (208) 382-4242 |
| NPI Number | 1003988825 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 02/13/2024 |
| Medicare PECOS PAC ID | 6103739719 |
|---|---|
| Medicare Enrollment ID | O20040309001351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003988825 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Ronald K Ellsworth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245556141 PECOS PAC ID: 3971778358 Enrollment ID: I20130723000595 |
| Provider Name | Chantell Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720432230 PECOS PAC ID: 4587951199 Enrollment ID: I20160926001820 |
| Provider Name | Katherine Louise Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881356087 PECOS PAC ID: 2769863943 Enrollment ID: I20220719002962 |
| Provider Name | Katie Camarata |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811429442 PECOS PAC ID: 2264786755 Enrollment ID: I20250411001844 |