MADISON CO MEMORIAL HOSPITAL (NPI# 1316460264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316460264 |
| Entity Type | Organization |
| Organization Name | MADISON CO MEMORIAL HOSPITAL |
| Other Organization Name | MADISON MEMORIAL OUTPATIENT SERVICES |
| Practice Address |
393 E 2nd N Rexburg ID 83440-1605 |
| Practice Telephone | (208) 356-5401 |
| Mailing Telephone | 2083565401 |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2020-02-21 |
| Authorized Official Name | TROY CHRISTENSEN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2083599802 |
| Is Organization Subpart | Y |
| Parent Organization Name | MADISON CO MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Madison Memorial Outpatient 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 |
| 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 |
| 1710294335 | Madison Co Memorial Hospital | Hospitalist | 450 E Main St, Rexburg, ID 83440-2048 | 2010-09-02 |
| 1538101100 | Madison Co Memorial Hospital | Internal Medicine | 36 Professional Plz, Suite 102, Rexburg, ID 83440-2049 | 2006-06-11 |
| Street Address |
393 E 2ND N |
| City | REXBURG |
| State | ID |
| Zip Code | 83440-1605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336140664 | Joseph Watson | Family Medicine | 393 E 2nd N, Rexburg, ID 83440-1605 | 2005-08-09 |
| 1871103499 | Kylin Kovac Dpm Pllc | Podiatrist | 393 E 2nd N, Rexburg, ID 83440-1605 | 2020-08-07 |
| 1609485457 | Kathy Howard | Counselor | 393 E 2nd N, Rexburg, ID 83440-1605 | 2020-07-28 |
| 1306497227 | Isaac Nelson | Counselor | 393 E 2nd N, Rexburg, ID 83440-1605 | 2019-09-23 |
| 1013562198 | Sharon Joyce Reaser | Marriage & Family Therapist | 393 E 2nd N, Rexburg, ID 83440-1605 | 2019-08-06 |
| 1558828236 | Centerpoint Psychiatry and Family Practice | Psychiatry & Neurology | 393 E 2nd N, Rexburg, ID 83440-1605 | 2019-02-28 |
| 1417427501 | Centerpoint Counseling Services, LLC | Social Worker | 393 E 2nd N, Rexburg, ID 83440 | 2018-11-30 |
| 1003312489 | Adriann J Wilcox | Family Medicine | 393 E 2nd N, Rexburg, ID 83440-1605 | 2018-04-04 |
| 1417455668 | Jana Rae O'rullian | Social Worker | 393 E 2nd N, Rexburg, ID 83440-1605 | 2018-01-23 |
| 1730602756 | Madison Co Memorial Hospital | Orthopaedic Surgery | 393 E 2nd N, Rexburg, ID 83440-1605 | 2017-07-21 |
| 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 | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649321134 | David L Day | General Practice | 32 W 1st S, Rexburg, ID 83440-1810 | 2007-01-13 |
| 1629182282 | Charles Jeffrey Zollinger | General Practice | 393 E 2nd N, Rexburg, ID 83440-1605 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508467051 | Janene Caldwell Witherite | General Practice | 1077 Stellar End Rd, Victor, ID 83455-4973 | 2020-11-02 |
| 1336797042 | Brightview Senior Health | General Practice | 1983 N Synergy Pl, Eagle, ID 83616-7332 | 2019-08-27 |
| 1346801941 | Daniel Campbell | General Practice | 2939 E Idavada Ct, Nampa, ID 83686-5899 | 2019-06-25 |
| 1932581089 | Matthew Hall | General Practice | 1232 Rigby Rd, Bancroft, ID 83217 | 2015-06-25 |
| 1881074201 | Lindsey Wells | General Practice | 2537 W State St Ste 110, Boise, ID 83702-2200 | 2015-06-01 |
| 1043697576 | William Chapman | General Practice | 1948 W. Blackwell Mill Road, Coeur D Alene, ID 83814 | 2015-05-05 |
| 1265824312 | Drugshield Inc | General Practice | 3085 N Cole Rd, Ste 108, Boise, ID 83704-5968 | 2015-02-26 |
| 1215344353 | Lanie Benson | General Practice | 460 N 3rd E, Driggs, ID 83422-5146 | 2014-07-22 |
| 1356614770 | Charles Thomas Mcgee | General Practice | 2385 W Bolivar Ave, Coeur D Alene, ID 83815-9134 | 2012-02-15 |
| 1487926564 | Boise Image Enhancement Centre, Inc. | General Practice | 9382 W Overland Rd, Boise, ID 83709-2505 | 2012-02-03 |
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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.