NPIMap

Organization Active NPI

Associates in Family Practice Inc

  • Family Medicine Physician
  • Gooding, ID
National Provider Identifier
1023030848
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ASSOCIATES IN FAMILY PRACTICE INC
Practice address
425 Idaho St
Gooding, ID 83330
Phone
(208) 934-5900
Fax
(208) 934-5719
NPI assigned
Jul 24, 2006
Last updated
Jan 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Authorized official

Name
Mrs. Susie Thompson
Title
Office Manager
Phone
(208) 934-5900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

425 Idaho St
Gooding, ID 83330

Mailing address

PO Box 500
Wendell, ID 83355
Phone (208) 536-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030724000006 ID Part A Provider - Rural Health Clinic 2163330325 Practice locations: Wendell, ID
O20031107000393 ID Part B Supplier - Clinic/Group Practice 2163330325 Receives reassigned benefits from 13 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wendell, ID; Hagerman, ID; Gooding, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023030848. Details of each certification follow.

Rural health clinic certification: CCN 133850

Legal name
ASSOCIATES IN FAMILY PRACTICE INC
Doing business as
ASSOCIATES IN FAMILY PRACTICE, PA
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 13, 2003
Last certification
Oct 13, 2003
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Jul 28, 1997 in ID
Enrollment address
410 N. Idaho Street
Wendell, ID 83355-5038

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Florian J Gies Individual 5% Or Greater Direct Ownership Interest Jul 27, 1997
Corporate Director Jul 24, 2003
Karen Rosa Individual W-2 Managing Employee Mar 18, 2011
Dana Gies Individual W-2 Managing Employee Jun 2, 2003

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1023030848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 500",
            "city": "WENDELL",
            "state": "ID",
            "postal_code": "83355",
            "telephone_number": "208-536-5900",
            "fax_number": "205-536-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 IDAHO ST",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "83330",
            "telephone_number": "208-934-5900",
            "fax_number": "208-934-5719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES IN FAMILY PRACTICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-934-5900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gooding, ID

Sources for this page

Verify at the official NPI Registry.