Family Health Services Corporation

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

FAMILY HEALTH SERVICES CORPORATION

Practice address

725 Fair St
Buhl, ID 83316-6442

Phone

(208) 543-8271

Fax

(208) 543-8272

NPI assigned

May 26, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Aaron Houston

Title

Cfo

Phone

(208) 734-3312

Specialties & licenses 10

Addresses

Other identifiers 1

Other names 1

• FAMILY HEALTH SERVICES Doing business as

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

Federally qualified health center certification: CCN 131811

Legal name

FAMILY HEALTH SERVICES CORPORATION

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jul 1, 1992

Last certification

Jul 1, 1992

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

Feb 22, 1982 in ID

Enrollment address

725 Fair St
Buhl, ID 83316-6442

Other NPIs on the same Medicare enrollment 35

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Burley, ID
  • NPI 1033165550

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Jerome, ID
  • NPI 1073188728

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Rupert, ID
  • NPI 1093761694

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1124571815

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Kimberly, ID
  • NPI 1154089795

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1194341388

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1235279217

  O20031229000479, O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Bellevue, ID
  • NPI 1245804400

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1255028221

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Declo, ID
  • NPI 1285297804

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1306462593

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1316563505

  O20040216000531

  Same enrollment

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

All facility ownership & control disclosures 21

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 67

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Duersch, M.D.

  • Family Medicine Physician
  • Jerome, ID
  • NPI 1902941750

  Family Medicine

  NPD
• Basil Clarence Anderson, M.D.

  • Family Medicine Physician
  • Kimberly, ID
  • NPI 1518282110

  Family Medicine

  NPD (past)
• Jesse J Balls, PA-C

  • Medical Physician Assistant
  • Jerome, ID
  • NPI 1487026191
  NPD (past)
• Jameson Bastow, DO

  • Family Medicine Physician
  • Jerome, ID
  • NPI 1639791361

  Family Medicine

  NPD (past)
• Abelardo Benitez

  • Physician Assistant
  • Twin Falls, ID
  • NPI 1093491706

  Family Medicine

  NPD (past)
• Nicolas A Bregante, PA-C

  • Medical Physician Assistant
  • Buhl, ID
  • NPI 1538485180

  Physician Assistant

  NPD (past)
• Kati Scarlett Bremers, FNP-C

  • Family Nurse Practitioner
  • Twin Falls, ID
  • NPI 1215880547
  NPD (past)
• Rebecca Cabello

  • Family Nurse Practitioner
  • Twin Falls, ID
  • NPI 1437921830
  NPD (past)
• Cathy White Canty, M.D.

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1013974658

  Family Medicine

  NPD (past)
• Allison Cluff, PA-C

  • Physician Assistant
  • Burley, ID
  • NPI 1922615848
  NPD (past)
• Keith E Davis, M.D.

  • Family Medicine Physician
  • Shoshone, ID
  • NPI 1043277635

  Family Medicine

  NPD (past)
• Joshua Clinton Dean, DDS

  • General Practice Dentistry
  • Buhl, ID
  • NPI 1790097905
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615939200000",
    "number": "1003862525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "794 EASTLAND DR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016856",
            "telephone_number": "208-734-3312",
            "fax_number": "208-734-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 FAIR ST",
            "city": "BUHL",
            "state": "ID",
            "postal_code": "833166442",
            "telephone_number": "208-543-8271",
            "fax_number": "208-543-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH SERVICES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "HOUSTON",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "208-734-3312",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "ID",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002547003",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY HEALTH SERVICES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAMILY HEALTH SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• County of Twin Falls Class a SCH Dist 412
• Dana L Nofziger MD PA
• Joshua Clinton Dean, DDS
• Desert View Care Center of Buhl, LLC
• Kristian Andress Escamilla
• Family Health Services Corporation
• Family Health Services Corporation
• Family Health Services Corporation
• Family Health Services Corporation
• Family Health Services Corporation

• All providers in Buhl, ID
• Federally Qualified Health Center (FQHC) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.