Active NPI
Obstetrics and Gynecology Associates of Idaho Falls
- Obstetrics & Gynecology Physician
- Idaho Falls, ID
National Provider Identifier
1164531943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- Legal business name
- OBSTETRICS AND GYNECOLOGY ASSOCIATES OF IDAHO FALLS
- Practice address
- 2065 E 17TH St
Suite D
Idaho Falls, ID 83404-8042 - Phone
- (208) 522-0747
- Fax
- (855) 830-4276
- NPI assigned
- Aug 29, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tess Hibbert
- Title
- Assistant Office Manager
- Phone
- (208) 522-0747
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | Primary |
Addresses
Primary practice location
2065 E 17TH St
Suite D
Idaho Falls, ID 83404-8042
Mailing address
2065 E 17TH St
Suite D
Idaho Falls, ID 83404-8042
Phone (208) 522-0747
Other names 1
- OB-GYN Assoc of Idaho Falls
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 13D0520943 | Obstetrics and Gynecology Associates | Compliance | Aug 29, 2026 |
National Provider Directory
National Provider DirectoryLocations
2065 E 17th St
Ste D
Idaho Falls, ID 83404
Phone (208) 522-0747
Practitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Medical Physician Assistant
- Idaho Falls, ID
- NPI 1164755104
-
- Medical Physician Assistant
- Idaho Falls, ID
- NPI 1477700573
-
- Anatomic Pathology & Clinical Pathology Physician
- Idaho Falls, ID
- NPI 1144264045
-
- Anatomic Pathology & Clinical Pathology Physician
- Idaho Falls, ID
- NPI 1093783375
-
- Anatomic Pathology & Clinical Pathology Physician
- Idaho Falls, ID
- NPI 1861461709
-
- Anatomic Pathology & Clinical Pathology Physician
- Winchester, VA
- NPI 1497734917
-
- Anatomic Pathology & Clinical Pathology Physician
- Kansas City, KS
- NPI 1457676181
-
- Anatomic Pathology Physician
- Rochester, MN
- NPI 1871090662
-
- Anatomic Pathology & Clinical Pathology Physician
- Durango, CO
- NPI 1013996412
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1675296000000",
"number": "1164531943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2065 E 17TH ST",
"address_2": "SUITE D",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834048042",
"telephone_number": "208-522-0747",
"fax_number": "208-522-9641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2065 E 17TH ST",
"address_2": "SUITE D",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834048042",
"telephone_number": "208-522-0747",
"fax_number": "855-830-4276"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OBSTETRICS AND GYNECOLOGY ASSOCIATES OF IDAHO FALLS",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-29",
"last_updated": "2023-02-02",
"certification_date": "2023-02-02",
"status": "A",
"authorized_official_last_name": "HIBBERT",
"authorized_official_first_name": "TESS",
"authorized_official_title_or_position": "ASSISTANT OFFICE MANAGER",
"authorized_official_telephone_number": "208-522-0747"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "OB-GYN Assoc of Idaho Falls",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "OB-GYN Assoc of Idaho Falls",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.