BOUNDARY REGIONAL COMMUNITY HEALTH CENTER INC NPI 1306883244

NPI Information

NPI: 1306883244
Provider Name: BOUNDARY REGIONAL COMMUNITY HEALTH CENTER INC

Doing Business As: KANIKSU COMMUNITY HEALTH

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
6615 COMANCHE ST
BONNERS FERRY, ID
ZIP 83805
Phone: (208) 267-1718
Get Directions

BOUNDARY REGIONAL COMMUNITY HEALTH CENTER INC is a federally qualified health center (fqhc) clinic center in Bonners Ferry, ID. BOUNDARY REGIONAL COMMUNITY HEALTH CENTER INC NPI is 1306883244. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Kaniksu Community Health.

The provider's business location address is:

6615 COMANCHE ST
BONNERS FERRY, ID
ZIP 83805
Phone: (208) 267-1718
Fax: (208) 267-7739

The provider's authorized official is Kevin Knepper .
The authorized official title is Chief Executive Officer and has the following contact phone number (208) 263-3410.

The enumeration date for this NPI number is 5/31/2006 and was last updated on 12/3/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine				No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0176255	OTHER	WASHINGTON	WA LABOR AND INDUSTRY
2	131822	OTHER		MEDICARE FQHC
3	806590100	MEDICAID	IDAHO
4	000010142695	OTHER	IDAHO	REGENCE OF IDAHO GROUP
5	807823200	OTHER	IDAHO	HEALTHY CONNECTIONS
6	8H104	OTHER	IDAHO	BLUE CROSS OF IDAHO GROUP
7	806591800	OTHER	IDAHO	HEALTHY CONNECTIONS
8	8905326	OTHER	WASHINGTON	WA L AND I CRIME VICTIMS
9	DB1056	OTHER		RAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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