Russet Ridge Healthcare LLC
NPI 1558154492ActiveOrganization· Skilled Nursing Facility· Boise, ID
Skilled Nursing Facility in Boise, Idaho, registered in NPPES in May 2025. The authorized official on file is Soon Burnam, Secretary. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1558154492 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 23, 2025 |
| Last updated in NPPES | Apr 15, 2026 |
| Certified by provider | Apr 15, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (ID) |
|---|
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