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SHOSHONE MEDICAL CENTER
NPI 1043215437
General Acute Care Hospital - Critical Access in Kellogg, ID

Active since June 14, 2005CLIA 13D0522232 · Certificate of Compliance
25 JACOBS GULCH RD, KELLOGG, ID 83837(208) 784-7017(208) 786-1019 Get Directions Write a Review

NPPES record last updated: April 27, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Shoshone Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHOSHONE MEDICAL CENTER (NPI 1043215437), doing business as West Shoshone Hospital District, is a healthcare organization registered as a critical access in Kellogg, Idaho and active in the NPI registry since June 2005. The organization holds a CLIA Certificate of Compliance certificate valid through June 18, 2027 and lists Donja Erdman, Cfo, as its authorized official.

NPPES Registry Identity

NPI1043215437
Entity TypeOrganization
Primary Taxonomy282NC0060X
Legal Business NameSHOSHONE MEDICAL CENTER
Location Address25 JACOBS GULCH RDKellogg, ID 83837-2023
Mailing Address25 Jacobs Gulch RdKellogg, ID 83837-2023 · (208) 784-7017 · Fax (208) 786-1019
Phone(208) 784-7017
Fax(208) 786-1019
Organization SubpartNo
Authorized OfficialDonja ErdmanCfo · (208) 784-1221
Enumeration DateJune 14, 2005
Last NPPES UpdateApril 27, 2021
NPPES CertifiedApril 27, 2021
✔ NPI 1043215437 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral Acute Care Hospital · Critical AccessHospitals
Taxonomy Code282NC0060X
License✔ Licensed in ID · 44
25 JACOBS GULCH RD, Kellogg, ID 83837
Open in Google Maps ↗

Other Names 1

Former Legal Business NameWest Shoshone Hospital District

Other Identifiers 12

Medicaid002862700ID
Other411320Montana Medicaid
Other3504605Montana Medicaid
Other86405ID · Blue Cross Of Idaho
Other00513ID · Blue Cross Of Idaho
Other10004Washington L & I
Medicaid002861800ID
Other000010000167ID · Regence
Other0082553Washington L & I
Medicaid002861700ID
Other3016300Washington Medicaid
Other7043250Washington Medicaid

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shoshone Medical Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

67

Medicare enrollment records show 67 clinicians reassign Medicare billing to Shoshone Medical Center, which bills Medicare for the services they deliver. Of these, 7 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 8

Diagnostic Radiology27
Emergency Medicine15
Family Practice9
Certified Registered Nurse Anesthetist (CRNA)5
Hospitalist5
Nurse Practitioner3
Internal Medicine2
Clinical Social Worker1

Nearest to this location (20)

See all 67
Tricia Dickens, MD
Emergency Medicine
NPI 1174542120
25 JACOBS GULCH RD STE 1
Kellogg, ID 83837
(208) 263-0649
✔ PECOSSame address
Benjamin Krasin, M.D.
Internal Medicine
NPI 1316327927
25 JACOBS GULCH RD
Kellogg, ID 83837
(208) 784-1221
✔ PECOS✔ Accepts MedicareSame address
Gwen Mckee, APRN
Nurse Practitioner
NPI 1043088222
25 JACOBS GULCH RD
Kellogg, ID 83837
(208) 784-1221
✔ PECOS✔ Accepts MedicareSame address
Farah Vega, MD
Hospitalist
NPI 1114389665
25 JACOBS GULCH RD
Kellogg, ID 83837
(208) 784-1221
✔ PECOS✔ Accepts MedicareSame address
Jennifer Porter, LCSW
Clinical Social Worker
NPI 1962889477
740 MCKINLEY AVE
Kellogg, ID 83837
(208) 783-1267
✔ PECOS✔ Accepts Medicare0.6 mi
Jocelyn Korasick, MD
Family Practice
NPI 1457346603
740 MCKINLEY AVE
Kellogg, ID 83837
(208) 783-1267
✔ PECOS✔ Accepts Medicare0.7 mi
Jessica Harnisch-Boyd, DO, MPH
Family Practice
NPI 1407319841
858 COMMERCE DRIVE
Smelterville, ID 83868
(208) 784-4612
✔ PECOS✔ Accepts Medicare2.8 mi
Tim Ochoa, DO
Family Practice
NPI 1609164417
229 S 7TH ST
St Maries, ID 83861
(208) 245-5551
✔ PECOS✔ Accepts Medicare26 mi
Marcus Harrell, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1407959380
101 W IRONWOOD DR STE 250
Coeur D Alene, ID 83814
(208) 765-8585
✔ Accepts Medicare32 mi
Eliessa Bell, MD
Family Practice
NPI 1760060719
1919 LINCOLN WAY
Coeur D Alene, ID 83814
(208) 625-4255
✔ PECOS✔ Accepts Medicare32 mi
Kelsey Kuipers, MD
Family Practice
NPI 1790429504
1919 LINCOLN WAY STE 315
Coeur D Alene, ID 83814
(208) 625-6029
✔ PECOS✔ Accepts Medicare32 mi
Bryan Berkey, MD
Diagnostic Radiology
NPI 1114917606
700 W IRONWOOD DR STE 175
Coeur D Alene, ID 83814
(208) 625-3000
✔ PECOS✔ Accepts Medicare32 mi
Devin Caywood, MD
Diagnostic Radiology
NPI 1962684571
700 W IRONWOOD DR STE 175
Coeur D Alene, ID 83814
(208) 625-6300
✔ PECOS✔ Accepts Medicare32 mi
Amit Chakraborty, MD
Diagnostic Radiology
NPI 1932342300
700 W IRONWOOD DR STE 175
Coeur D Alene, ID 83814
(208) 625-6300
✔ PECOS✔ Accepts Medicare32 mi
Josh Leppert, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1013322346
2003 KOOTENAI HEALTH WAY
Coeur D Alene, ID 83814
(208) 765-8585
✔ Accepts Medicare33 mi
Craig Panos, M. D.
Emergency Medicine
NPI 1104855188
980 W IRONWOOD DR STE 206
Coeur D Alene, ID 83814
(208) 215-2030
✔ PECOS✔ Accepts Medicare33 mi
Anthony Rehil-Crest, MD
Internal Medicine
NPI 1114152980
1090 W PARK PL
Coeur D Alene, ID 83814
(208) 215-2005
✔ PECOS✔ Accepts Medicare33 mi
Heather King, NP-C
Nurse Practitioner
NPI 1164895371
913 W CANFIELD AVE
Coeur D Alene, ID 83815
(208) 763-8920
✔ PECOS✔ Accepts Medicare34 mi
Ann Moffett, NP-C
Nurse Practitioner
NPI 1578061883
858 COMMERCE DR.
Smelterville, ID 83858
(208) 784-4612
✔ PECOS✔ Accepts Medicare39 mi
Geoffrey Mckinzie, M.D.
Emergency Medicine
NPI 1942417670
497 S BECK RD
Post Falls, ID 83854
(208) 691-7690
✔ PECOS43 mi
See all 67 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 13D0522232

Shoshone Medical Center · Kellogg, ID
Active · expires Jun 18, 2027
CLIA Number13D0522232
Laboratory TypeHospital
Certificate Effective DateJune 19, 2025
Certificate Expiration DateJune 18, 2027
Laboratory DirectorDr. Heather Gridley
Laboratory Phone(208) 784-1221
Laboratory LocationShoshone Medical Center25 Jacobs Gulch Rd, Kellogg, ID 83837
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Hospital Quality Ratings CMS Care Compare

Quality and patient-experience ratings for Shoshone Medical Center (CMS certification number 131314), from CMS Care Compare.

Shoshone Medical Center

Critical Access Hospitals · Kellogg, ID
OwnershipGovernment - Hospital District or Authority
CMS Certification Number131314
Location25 Jacobs Gulch RoadKellogg, ID 83837 · Shoshone County · (208) 784-1221
Emergency services

Complications & Deaths 5

Death rate for heart attack patients
Cases too small to report
Death rate for COPD patients
Cases too small to report
Death rate for heart failure patients
Cases too small to report
Death rate for pneumonia patients
23.2% No different than national
Death rate for stroke patients
Cases too small to report

Unplanned Hospital Visits 11

Hospital return days for heart attack patients
Cases too small to report
Hospital return days for heart failure patients
Cases too small to report
Hospital return days for pneumonia patients
38 days per 100 discharges
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)
92 No different than national
Rate of inpatient admissions for patients receiving outpatient chemotherapy
Cases too small to report
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy
Cases too small to report

Timely & Effective Care 2

Healthcare workers given influenza vaccination
50%
Average (median) time patients spent in the emergency department before leaving from the visit A lower number of minutes is better
97 minutes

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shoshone Medical Center's NPI number?

The NPI number for Shoshone Medical Center is 1043215437. It was assigned to this organization in the NPPES registry on June 14, 2005. The provider was formerly known as West Shoshone Hospital District.

Where is Shoshone Medical Center located?

Shoshone Medical Center is located at 25 Jacobs Gulch Rd, Kellogg, ID 83837. The listed phone number is (208) 784-7017.

What is Shoshone Medical Center's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital, specializing in Critical Access, with taxonomy code 282NC0060X.

Is Shoshone Medical Center enrolled in Medicare?

Yes. Shoshone Medical Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Shoshone Medical Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 67 clinicians in 8 Medicare specialties reassign their Medicare billing to Shoshone Medical Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (27), Emergency Medicine (15) and Family Practice (9). Of these, 7 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Shoshone Medical Center hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 13D0522232) is associated with this NPI, valid through June 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Shoshone Medical Center a Medicare-certified hospital?

Yes. Shoshone Medical Center is a Medicare-certified hospital (Critical Access Hospitals). The hospital provides emergency services.

What insurance does Shoshone Medical Center accept?

Health plans from Molina Healthcare, PacificSource Health Plans, Providence Health Plan and Select Health list Shoshone Medical Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shoshone Medical Center was last updated on April 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.