Rexburg Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M4211 Issued in ID

Legal business name

REXBURG MEDICAL CENTER

Practice address

393 E 2ND N
Rexburg, ID 83440

Phone

(208) 356-5401

Fax

(208) 356-3111

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Mary Zollinger

Title

Administrator

Phone

(208) 356-5401

Specialties & licenses 1

Addresses

Other identifiers 2

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

CLIA laboratory certificates

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114010782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E 2ND N",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "83440",
            "telephone_number": "208-356-5401",
            "fax_number": "208-356-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 E 2ND N",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "83440",
            "telephone_number": "208-356-5401",
            "fax_number": "208-356-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REXBURG MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZOLLINGER",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-356-5401",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M4211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "29920",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8981-3",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Reed
• Sondra Reeder
• Rehab & Industrial Services, LLP
• Rexburg Chiropractic Center
• Rexburg Family Medical Center, PLLC
• Rexburg Surgery Center LLC
• Rexburg Vision Center
• Chelse Reynolds
• Heather Linn Rich, M.A. CCC-SLP
• Emily Richards

• Family Medicine Physician in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.