Madison Co Memorial Hospital
NPI 1134592017ActiveOrganization· Family Medicine· Rexburg, ID
Family Medicine in Rexburg, Idaho, registered in NPPES in November 2015, part of Madison Co Memorial Hospital. The authorized official on file is Rachel Gonzales, DM, RN, RODP, Chief Executive Officer. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1134592017 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Madison Co Memorial Hospital |
| NPI issued | Nov 2, 2015 |
| Last updated in NPPES | Oct 23, 2023 |
| Certified by provider | Oct 23, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | 40 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (ID) |
|---|
Other Family Medicine providers in Rexburg
- 1558828236
- 1184647307
- 1649693649
- 1790244424
- 1942107826
- 1649847823
- 1659914802
- 1649699216
- 1114010782
- 1467394510
- 1154502615
- 1922237874