MADISON CO MEMORIAL HOSPITAL (NPI# 1710294335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710294335 |
| Entity Type | Organization |
| Organization Name | MADISON CO MEMORIAL HOSPITAL |
| Other Organization Name | MADISON MEMORIAL HOSPITALIST SERVICES |
| Practice Address |
450 E Main St Rexburg ID 83440-2048 |
| Mailing Address |
Po Box 700 Rexburg ID 83440-0700 |
| Practice Telephone | 2083563691 |
| Practice Fax Number | 2083596764 |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2012-05-02 |
| Authorized Official Name | MRS. RACHEL A GONZALES (CEO) |
| Authorized Official Telephone | 2083563691 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208M00000X | Hospitalist | 40 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE PTAN | 12577281 | 01 |
| Other Name | Type Code |
|---|---|
| Madison Memorial Hospitalist Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992747570 | Madison Co Memorial Hospital | General Acute Care Hospital | 450 E. Main, Rexburg, ID 83440 | 2006-06-11 |
| 1073154266 | Madison Co Memorial Hospital | Pediatrics | 37 S 2nd E, Rexburg, ID 83440-1906 | 2019-09-30 |
| 1316460264 | Madison Co Memorial Hospital | General Practice | 393 E 2nd N, Rexburg, ID 83440-1605 | 2017-07-24 |
| 1730602756 | Madison Co Memorial Hospital | Orthopaedic Surgery | 393 E 2nd N, Rexburg, ID 83440-1605 | 2017-07-21 |
| 1134592017 | Madison Co Memorial Hospital | Family Medicine | 393 E 2nd N, Rexburg, ID 83440-1605 | 2015-11-02 |
| 1538101100 | Madison Co Memorial Hospital | Internal Medicine | 36 Professional Plz, Suite 102, Rexburg, ID 83440-2049 | 2006-06-11 |
| Street Address |
450 E MAIN ST |
| City | REXBURG |
| State | ID |
| Zip Code | 83440-2048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639111206 | Madison Physician Services | Emergency Medicine | 450 E Main St, Rexburg, ID 83440-2048 | 2006-06-11 |
| 1396352142 | Karissa Thueson | Nurse Practitioner | 450 E Main St, Rexburg, ID 83440-2048 | 2020-09-25 |
| 1376192674 | David Howard Anderson | Pharmacist | 450 E Main St, Rexburg, ID 83440-2048 | 2019-09-09 |
| 1124676663 | Susan B Clark | Dietitian, Registered | 450 E Main St, Rexburg, ID 83440-2048 | 2019-08-28 |
| 1790278760 | Allen Terry Miller | Pharmacist | 450 E Main St, Rexburg, ID 83440-2048 | 2018-06-13 |
| 1831682194 | Dorsie Thomas Sullenger | Pharmacist | 450 E Main St, Rexburg, ID 83440-2048 | 2018-06-12 |
| 1184122756 | Steven Craig Pierce | Physician Assistant | 450 E Main St, Rexburg, ID 83440-2048 | 2018-01-29 |
| 1215471065 | Troy Hanson | Nurse Practitioner | 450 E Main St, Rexburg, ID 83440-2048 | 2016-12-13 |
| 1346692605 | University of Utah Pediatric Services | Pediatrics | 450 E Main St, Rexburg, ID 83440-2048 | 2016-07-11 |
| 1871941724 | Justin Shippen | Family Medicine | 450 E Main St, Rexburg, ID 83440-2048 | 2016-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235768490 | Henry's Fork Surgery Center Pllc | Clinic/Center | 23 Sawtelle Ave, Rexburg, ID 83440 | 2020-04-08 |
| 1952956906 | Shane Ellis Withers | Pharmacist | 164 E. Main, Rexburg, ID 83440 | 2019-08-06 |
| 1316392285 | Emma Anderson | Speech-Language Pathologist | 36 Professional Plaza Suite 110, Rexburg, ID 83440 | 2016-04-28 |
| 1851755524 | Sandra Frickey | Speech-Language Pathologist | 1087 Summers Drive, Premier Therapy Associates, Rexburg, ID 83440 | 2016-04-08 |
| 1275997215 | Kerry Denney | Counselor | 333 Walker Drive, Rexburg, ID 83440 | 2016-04-06 |
| 1467837583 | Wal-mart Stores, Inc. | Technician/Technologist | 303 E Moody Rd, Rexburg, ID 83440 | 2015-07-30 |
| 1649692609 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 410 W 1st N, Rexburg, ID 83440 | 2014-01-10 |
| 1043652571 | Creed Simon Webster | Counselor | 30 S 2nd W, Rexburg, ID 83440 | 2013-07-25 |
| 1033461660 | James Cannon Allen Dds PC | Dentist | 106 E 1st North, Rexburg, ID 83440 | 2012-10-05 |
| 1417217316 | Shelby Dee Woolstenhulme | Speech-Language Pathologist | 450 E. Main Street, Rexburg, ID 83440 | 2012-05-24 |
| Find all providers in zip 83440 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477197036 | Megan Lenkersdorfer | Hospitalist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-11-06 |
| 1790343580 | Snake River Hospitalists, LLC | Hospitalist | 2325 Coronado St, Idaho Falls, ID 83404-7407 | 2019-06-05 |
| 1225564925 | Bryce L Arnold | Hospitalist | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2017-05-02 |
| 1740715507 | Santibanez Aguirre PC | Hospitalist | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2017-04-28 |
| 1528593381 | Lauren Franklin | Hospitalist | 1055 N Curtis Rd, Boise, ID 83706 | 2017-04-28 |
| 1114389665 | Farah Esther Vega | Hospitalist | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2016-03-23 |
| 1790150514 | Pocatello Inpatient Services Pllc | Hospitalist | 777 Hospital Way, Pocatello, ID 83201-5175 | 2015-12-04 |
| 1285014118 | Lyon Medical LLC | Hospitalist | 3080 E Gentry Way Ste 100, Meridian, ID 83642-3060 | 2015-06-05 |
| 1902285257 | Kanan Silvas | Hospitalist | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2015-05-20 |
| 1780078626 | Hinah Gul Parker | Hospitalist | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2015-03-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.