NPIMap

Organization Active NPI

Madison Co Memorial Hospital

Doing business as Seasons Medical By Madison Memorial

  • Obstetrics & Gynecology Physician
  • Rexburg, ID
National Provider Identifier
1073154266
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MADISON CO MEMORIAL HOSPITAL
Doing business as
Seasons Medical By Madison Memorial
Practice address
37 S 2ND E
Rexburg, ID 83440-1906
Phone
(208) 356-0234
NPI assigned
Sep 30, 2019
Last updated
Mar 5, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MADISON CO MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Authorized official

Name
Rachel Gonzales, DM, RN, RODP
Title
Chief Executive Officer
Phone
(208) 359-6900

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

37 S 2ND E
Rexburg, ID 83440-1906

Mailing address

37 S 2ND E
Rexburg, ID 83440-1906
Phone (208) 656-8454

Other practice location 1

477 Pleasant Country Ln
Rigby, ID 83442-5278
Phone (208) 356-0234

Other names 1

  • Seasons Medical By Madison Memorial Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040505000664 ID Part B Supplier - Clinic/Group Practice 8123016367 Receives reassigned benefits from 45 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rexburg, ID; Rigby, ID
O20050707000644 ID Part A Provider - Hospital 8123016367 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rexburg, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073154266. Details of each certification follow.

Hospital certification: CCN 130025

Legal name
MADISON CO MEMORIAL HOSPITAL
Doing business as
MADISON MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jun 28, 2018
Beds
81
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
450 E Main St
Rexburg, ID 83440-2048
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 7

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Madison Memorial HospitalCCN 130025 · All quality measures
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Madison Co Memorial Hos

Locations

477 Pleasant Country Ln
Rigby, ID 83442
Phone (208) 356-0234

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Marshall Merrell Individual Other Apr 13, 2006
Holly Forbush Individual Other Jan 22, 2015
Rachel Gonzales Individual Corporate OfficerCeo Jun 25, 2008
Jerry Rigby Individual Other Apr 18, 2011
Joseph Troy Christensen Individual Corporate OfficerCfo Aug 1, 2013
Maurie Barton Individual Other Apr 18, 2011
Ken Burt Individual Other Jun 30, 1999
Scott Dixon Individual Other Sep 4, 2012
Taunia Berrett Individual W-2 Managing Employee Jan 1, 2011
Neil Erickson Individual Other Apr 18, 2011
Dan Kettle Individual Other Jan 24, 2018

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

Affiliated clinicians 180

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 180

NPI Registry JSON

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1073154266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 S 2ND E",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401906",
            "telephone_number": "208-656-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 S 2ND E",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401906",
            "telephone_number": "208-356-0234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "477 Pleasant Country Ln",
            "address_purpose": "LOCATION",
            "city": "Rigby",
            "state": "ID",
            "postal_code": "834425278",
            "country_code": "US",
            "telephone_number": "208-356-0234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MADISON CO MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MADISON CO MEMORIAL HOSPITAL",
        "enumeration_date": "2019-09-30",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "208-359-6900",
        "authorized_official_credential": "DM, RN, RODP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seasons Medical By Madison Memorial",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seasons Medical By Madison Memorial",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rexburg, ID

Sources for this page

Verify at the official NPI Registry.