NPI age
20 years
Enumerated 2005-06-14
● Active Type 2 · Organization
Shoshone Medical Center
Shoshone Medical Center is 1 of 55 general acute care hospital organizations in Idaho.
Primary specialty
General Acute Care Hospital
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Erdman
Cfo
Last NPPES update
2021-04-27
Source: monthly bulk 2026-05
How this organization compares
Across 55 active general acute care hospital providers in Idaho.
NPI age
20 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2005 → 2026
2005-06Enumerated in NPPES
2005
2026
Where they practice
Primary practice location
25 Jacobs Gulch Rd
Kellogg, ID 838372023
Mailing address
25 Jacobs Gulch Rd
Kellogg, ID 838372023
Authorized official
Donja Erdman
Cfo
📞 2087841221
Individual providers at this organization
9 individual providers on file at this primary practice address.
- Jennifer Backman, DO Family Medicine NPI 1306862388
- Thomas Heston, M.D. Family Medicine NPI 1861447245
- Benjamin Krasin, M.D. Internal Medicine NPI 1316327927
- Gwen McKee, APRN Nurse Practitioner NPI 1043088222
- Megan Mills, LPC Counselor NPI 1003656331
- Emma Stayduhar Physical Medicine & Rehabilitation NPI 1164903076
- Joanne Swiatek Occupational Therapist NPI 1962981951
- Farah Vega, MD Hospitalist NPI 1114389665
- Adrianne Vest, PTA Physical Therapy Assistant NPI 1871441485
Specialties
-
General Acute Care Hospital PrimaryDefinition to come.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 86405 | BLUE CROSS OF IDAHO |
| 01 | 3504605 | MONTANA MEDICAID |
| 05 (ID) | 002862700 | |
| 01 | 3016300 | WASHINGTON MEDICAID |
| 01 | 0082553 | WASHINGTON L & I |
| 01 | 411320 | MONTANA MEDICAID |
| 01 (ID) | 000010000167 | REGENCE |
| 05 (ID) | 002861700 | |
| 01 (ID) | 00513 | BLUE CROSS OF IDAHO |
| 01 | 10004 | WASHINGTON L & I |
| 01 | 7043250 | WASHINGTON MEDICAID |
| 05 (ID) | 002861800 |
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
WEST SHOSHONE HOSPITAL DISTRICT
-
WEST SHOSHONE HOSPITAL DISTRICT
Practice context
Multi-provider organization. 9 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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