| Kootenai Tribal Health Clinic | |
|
100 Circle Drive Bonners Ferry ID 83805-1279 | |
| (208) 267-5223 | |
| (208) 267-8419 |
| Full Name | Kootenai Tribal Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 Circle Drive, Bonners Ferry, Idaho |
| Authorized Official Name and Position | Karen K Hanson (HEALTH CLINIC DIRECTOR) |
| Authorized Official Contact | 2082675223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kootenai Tribal Health Clinic Po Box T Bonners Ferry ID 83805-1279 Ph: (208) 267-5223 | Kootenai Tribal Health Clinic 100 Circle Drive Bonners Ferry ID 83805-1279 Ph: (208) 267-5223 |
| NPI Number | 1669594057 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 10/21/2010 |
| Medicare PECOS PAC ID | 7315184926 |
|---|---|
| Medicare Enrollment ID | O20130517000477 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669594057 | NPI | - | NPPES |
| G007100 | Medicaid | ID | |
| DC786 | Other | ID | BLUE CROSS |
| DC786 | Other | ID | HMO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Ligeia A Reinhardt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871584755 PECOS PAC ID: 3678525268 Enrollment ID: I20050211000135 |
| Provider Name | Pamela A Schudar-svec |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1619021441 PECOS PAC ID: 3971517673 Enrollment ID: I20060202000154 |
| Provider Name | Christopher M Kolobow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700277688 PECOS PAC ID: 0941529895 Enrollment ID: I20150428000634 |
| Provider Name | Kimberly Ruth Carey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073135851 PECOS PAC ID: 8628457751 Enrollment ID: I20220621002343 |
| Provider Name | Jeanne B Racer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245986264 PECOS PAC ID: 7810376670 Enrollment ID: I20220624000913 |
| Provider Name | Dan Michael Tadlock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124397476 PECOS PAC ID: 2264804616 Enrollment ID: I20230210001272 |
Main Street Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6641 Kaniksu St, Suite A, Bonners Ferry, ID 83805 Phone: 208-265-3655 Fax: 208-267-3757 | |
Kaniksu Community Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6615 Comanche St, Bonners Ferry, ID 83805 Phone: 208-267-1718 Fax: 208-267-7739 | |
Cornerstone Urgent Care & Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 32 David Thompson Dr Ste A, Bonners Ferry, ID 83805 Phone: 208-267-3934 | |
Diehl Internal Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6640 Kaniksu St, Bonners Ferry, ID 83805 Phone: 540-454-1848 | |
Kaniksu Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6635 Comanche St, Bonners Ferry, ID 83805 Phone: 208-267-1718 Fax: 208-267-7739 | |
Boundary Community Clinics Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6641 Kaniksu St, Bonners Ferry, ID 83805 Phone: 208-267-3655 Fax: 208-267-3757 |