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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: August 09, 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 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 10

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

MEGAN MILLS LPC
Counselor (Mental Health)
25 JACOBS GULCH RD
KELLOGG, ID 83837
Shoshone County (208) 784-1221
GWEN LORRAINE MCKEE APRN
Nurse Practitioner (Family)
25 JACOBS GULCH RD
KELLOGG, ID 83837
Shoshone County (208) 784-1221
FARAH ESTHER VEGA MD
Hospitalist
25 JACOBS GULCH RD
KELLOGG, ID 83837
Shoshone County (208) 784-1221
EMMA STAYDUHAR
Physical Medicine & Rehabilitation
25 JACOBS GULCH RD
KELLOGG, ID 83837
Shoshone County (208) 784-4603
JENNIFER BACKMAN DO
Family Medicine
25 JACOBS GULCH RD
KELLOGG, ID 83837
Shoshone County (208) 784-1221
BENJAMIN COLLINS KRASIN M.D.
Internal Medicine
25 JACOBS GULCH RD
KELLOGG, ID 83837
Shoshone County (208) 784-1221
SHOSHONE MEDICAL CENTER
General Acute Care Hospital (Critical Access)
25 JACOBS GULCH RD
KELLOGG, ID 83837
Shoshone County (208) 784-1228
THOMAS F HESTON M.D.
Family Medicine
25 JACOBS GULCH RD
KELLOGG, ID 83837
Shoshone County (208) 783-1267

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.

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 PacificSource Health Plans and Providence Health Plan 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.