| Boundary Regional Community Health Center, Inc. | |
|
6509 Highway 2 Suite 101 Priest River ID 83856-6609 | |
| (208) 448-2321 | |
| (208) 448-1317 |
| Full Name | Boundary Regional Community Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 6509 Highway 2, Priest River, Idaho |
| Authorized Official Name and Position | Kevin Knepper (CEO) |
| Authorized Official Contact | 2082633410 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boundary Regional Community Health Center, Inc. Po Box 2160 Sandpoint ID 83864-0908 Ph: (208) 263-3410 | Boundary Regional Community Health Center, Inc. 6509 Highway 2 Suite 101 Priest River ID 83856-6609 Ph: (208) 448-2321 |
| NPI Number | 1538447727 |
|---|---|
| Provider Enumeration Date | 07/22/2011 |
| Last Update Date | 12/03/2021 |
| Medicare PECOS PAC ID | 2264341221 |
|---|---|
| Medicare Enrollment ID | O20050211000195 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538447727 | NPI | - | NPPES |
| DB1056 | Other | ID | RAILROAD MEDICARE |
| Provider Name | Ligeia A Reinhardt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871584755 PECOS PAC ID: 3678525268 Enrollment ID: I20050211000135 |
| Provider Name | Ann Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033270236 PECOS PAC ID: 8729180047 Enrollment ID: I20070216000313 |
| Provider Name | Hailey Rose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679702088 PECOS PAC ID: 0749431666 Enrollment ID: I20121127000065 |
| Provider Name | Nelson Antoniuk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588609176 PECOS PAC ID: 5193769016 Enrollment ID: I20160229000907 |
| Provider Name | Erin Bass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063872604 PECOS PAC ID: 1658660691 Enrollment ID: I20160516000848 |
| Provider Name | Joseph A Wassif |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144695818 PECOS PAC ID: 8325300015 Enrollment ID: I20180316000343 |
| Provider Name | Elisabeth Marie Mackey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033665278 PECOS PAC ID: 6406134469 Enrollment ID: I20180614001452 |
| Provider Name | Angella R Julagay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659763951 PECOS PAC ID: 0446577068 Enrollment ID: I20190211000652 |
| Provider Name | Robert T Rossi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205211786 PECOS PAC ID: 1153669411 Enrollment ID: I20190212000313 |
| Provider Name | Magno C Santos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881935104 PECOS PAC ID: 0143454173 Enrollment ID: I20190604001208 |
| Provider Name | Benjamin S Stockton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124476072 PECOS PAC ID: 7214220045 Enrollment ID: I20200120000258 |
| Provider Name | Shannon Marie Seckel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316468002 PECOS PAC ID: 3476823626 Enrollment ID: I20200701001927 |
| Provider Name | Sara Marie Hull |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619592912 PECOS PAC ID: 2961825674 Enrollment ID: I20200713003240 |
| Provider Name | David S Moran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841531647 PECOS PAC ID: 3678906088 Enrollment ID: I20210513002459 |
| Provider Name | Dean M Jennings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831524537 PECOS PAC ID: 5092112045 Enrollment ID: I20210920000074 |
| Provider Name | Nicole E Russell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982017968 PECOS PAC ID: 1759601230 Enrollment ID: I20220307002347 |
| Provider Name | Autumn Diller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134695091 PECOS PAC ID: 3476940313 Enrollment ID: I20220425001277 |
| Provider Name | Eric D Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649927245 PECOS PAC ID: 8527441971 Enrollment ID: I20220817001611 |
| Provider Name | Tammy L Undiemi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073178133 PECOS PAC ID: 7315359288 Enrollment ID: I20230308001980 |
| Provider Name | Mary Danielle Kuykendall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609556596 PECOS PAC ID: 2860855269 Enrollment ID: I20230901001259 |
| Provider Name | Stacy N Luce |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114286358 PECOS PAC ID: 4385095959 Enrollment ID: I20240108004972 |
| Provider Name | Kimberly A Rutland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073174199 PECOS PAC ID: 7911311642 Enrollment ID: I20240207003673 |
| Provider Name | Tara L Vizcarra |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316471717 PECOS PAC ID: 9032487194 Enrollment ID: I20240307000823 |
| Provider Name | Andrew B Vizcarra |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629502265 PECOS PAC ID: 7810265071 Enrollment ID: I20240405001398 |
| Provider Name | Joshua A Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700424041 PECOS PAC ID: 3779922877 Enrollment ID: I20240423001476 |
| Provider Name | Tiffany A Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033749262 PECOS PAC ID: 6608312210 Enrollment ID: I20240719000018 |
| Provider Name | Pamela J Skon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912325713 PECOS PAC ID: 8820210727 Enrollment ID: I20240730003029 |
| Provider Name | Caleb J Orr |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699257568 PECOS PAC ID: 0840723573 Enrollment ID: I20241101001818 |
| Provider Name | Paula Emerton-godwin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710700703 PECOS PAC ID: 9032644836 Enrollment ID: I20241202003369 |
Pend Oreille Vision Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6132 Highway 2, Priest River, ID 83856 Phone: 208-448-0144 Fax: 208-448-0147 |