GRANDE RONDE HOSPITAL, INC
NPI 1497807812
Internal Medicine - Cardiovascular Disease in Boise, ID
NPI Status: Active since January 17, 2007
Contact Information
300 E JEFFERSON ST STE 101
BOISE, ID
ZIP 83712
Phone: (208) 336-4141
Fax: (208) 336-4035
- Organization
- Internal Medicine
- Cardiovascular Disease
- CLIA Number: 38D2153754
- CLIA Cert. Type: Ancillary Testing Site in Health Care Center
- CLIA Exp. Date: 08-28-2026
About GRANDE RONDE HOSPITAL, INC
This page provides the complete NPI Profile along with additional information for Grande Ronde Hospital, Inc, an internist established in Boise, Idaho operating as a Internal Medicine, focusing in cardiovascular disease . The healthcare provider is registered in the NPI registry with number 1497807812 assigned on January 2007. The practitioner's primary taxonomy code is 207RC0000X with license number 14-0728 (OR). The provider is registered as an organization and their NPI record was last updated 14 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Mr. James Mattes (President Ceo)
- NPI
- 1497807812
- Provider Name
- GRANDE RONDE HOSPITAL, INC
- Entity Type
- Organization
- Location Address
- 300 E JEFFERSON ST STE 101 BOISE, ID 83712
- Location Phone
- (208) 336-4141
- Location Fax
- (208) 336-4035
- Mailing Address
- PO BOX 3290 LA GRANDE, OR 97850
- Mailing Phone
- (541) 963-1555
- Mailing Fax
- (208) 336-4035
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-17-2007
- Last Update Date
- 04-07-2011
- Code Navigator
An internist like Grande Ronde Hospital, Inc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Cardiovascular Disease
- Taxonomy Code
- 207RC0000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 14-0728
- License State
- OR
- Taxonomy Description
- An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1368978 | MEDICARE ID-TYPE UNSPECIFIED (04) | ID | CIGNA MEDICARE-ECHOS |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 38D2153754
- Facility Type
- Ancillary Testing Site in Health Care Center
- Certificate Effective Date
- August 29, 2024
- Certificate Expiration Date
- August 28, 2026
- Laboratory Director
- NICOLE TURNER MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Grande Ronde Hospital, Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 9 | 7 | 8 | 0 | 7 | 8 | 1 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 18 | 7 | 16 | 0 | 14 | 8 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 8 + 7 + 1 + 6 + 0 + 1 + 4 + 8 + 2 + 24 = 68 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 68 = 2 | 2 | ||||||||
The NPI number 1497807812 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 7 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1295189264 | DR. SEAN M. SMART DNP Individual | Nurse Practitioner (Family) | 300 E JEFFERSON ST STE 101 BOISE, ID 83712 (208) 322-1680 |
| 1841782083 | ATHENA DENICE EVANS-CAMPBELL Individual | Registered Nurse | 300 E JEFFERSON ST STE 101 BOISE, ID 83712 (208) 388-7183 |
| 1831335660 | DR. TROY J BADGER MD Individual | Internal Medicine (Cardiovascular Disease) | 300 E JEFFERSON ST STE 101 BOISE, ID 83712 (208) 322-1680 |
| 1588256846 | DR. LYDIA MARIE MOOR CNP Individual | Nurse Practitioner (Acute Care) | 300 E JEFFERSON ST STE 101 BOISE, ID 83712 (208) 322-1680 |
| 1093825903 | JENNIFER S ANDERSON MD Individual | Internal Medicine | 300 E JEFFERSON ST STE 101 BOISE, ID 83712 (208) 322-1680 |
| 1023210515 | DR. DAVID JOSEPH COYLE M.D. Individual | Internal Medicine (Interventional Cardiology) | 300 E JEFFERSON ST STE 101 BOISE, ID 83712 (208) 322-1680 |
| 1730512369 | ROBYN BRYDE MD Individual | Internal Medicine (Cardiovascular Disease) | 300 E JEFFERSON ST STE 101 BOISE, ID 83712 (208) 223-1680 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1497807812, enumerated in the NPI registry as an "organization" on January 17, 2007
The provider is located at 300 E Jefferson St Ste 101 Boise, Id 83712 and the phone number is (208) 336-4141
This medical organization specializes in Internal Medicine with taxonomy code 207RC0000X with a focus in Cardiovascular Disease
The provider might be accepting Accepts: Cigna, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 38D2153754 for a "ancillary testing site in health care center" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on January 17, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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