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

Q: What is the provider's specialty?

The provider's specialty is General Acute Care Hospital with taxonomy code 282NC0060X and a focus in Critical Access.

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: July 19, 2026.

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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

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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 PacificSource Health Plans, Providence Health Plan.Insurance ›

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 stroke patients

Cases too small to report

Death rate for pneumonia patients

23.2% No different than national

Death rate for heart failure patients

Cases too small to report

Death rate for COPD patients

Cases too small to report

Death rate for heart attack patients

Cases too small to report

Unplanned Hospital Visits 11

Pneumonia (PN) 30-Day Readmission Rate

38 No different than national

Rate of readmission after discharge from hospital (hospital-wide)

105 No different than national

Heart failure (HF) 30-Day Readmission Rate

Cases too small to report

Rate of readmission for chronic obstructive pulmonary disease (COPD) patients

25 No different than national

Acute Myocardial Infarction (AMI) 30-Day Readmission Rate

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

Average (median) time patients spent in the emergency department before leaving from the visit A lower number of minutes is better

97 minutes

Healthcare workers given influenza vaccination

50%

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THOMAS F HESTON M.D.

Family Medicine