Fremont Medical Center, PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

FREMONT MEDICAL CENTER, PLLC

Practice address

30 W Main St
Saint Anthony, ID 83445-2113

Phone

(208) 624-2969

NPI assigned

Sep 12, 2022

Last updated

Dec 8, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jamie Gudmunson, FNP-CNPI 1669853719

Title

Owner/ Nurse Practitioner

Phone

(208) 624-2969

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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.

• Jamie Gudmunson

  • Family Nurse Practitioner
  • Saint Anthony, ID
  • NPI 1669853719
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670457600000",
    "number": "1043931637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MAIN ST",
            "city": "SAINT ANTHONY",
            "state": "ID",
            "postal_code": "834452113",
            "telephone_number": "208-624-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W MAIN ST",
            "city": "SAINT ANTHONY",
            "state": "ID",
            "postal_code": "834452113",
            "telephone_number": "208-624-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREMONT MEDICAL CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "GUDMUNSON",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER/ NURSE PRACTITIONER",
        "authorized_official_telephone_number": "208-624-2969",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Excellence in Everyone, LLC
• Expressions Supportive Services, LLC
• Charlotte A Fatafehi, LCSW
• Fremont Family Medicine PC
• Fremont Joint School District #215
• Fremont Medical Services PC
• Fremont Physical Therapy PLLC
• Jamie Gudmunson
• Amberly Guymon, LMSW
• Mary Christine Harvey, LM, CPM

• Clinic/Center in Saint Anthony, ID
• Providers in Saint Anthony, ID by specialty
• Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.