Healthcare Provider Details

I. General information

NPI: 1538447727
Provider Name (Legal Business Name): BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2011
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6509 HIGHWAY 2 SUITE 101
PRIEST RIVER ID
83856-6609
US

IV. Provider business mailing address

PO BOX 2160
SANDPOINT ID
83864-0908
US

V. Phone/Fax

Practice location:
  • Phone: 208-448-2321
  • Fax: 208-448-1317
Mailing address:
  • Phone: 208-263-3410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KEVIN KNEPPER
Title or Position: CEO
Credential:
Phone: 208-263-3410