Individual provider Active NPI

Gladys Marie Rasch, MPA-C

  • Medical Physician Assistant
  • Twin Falls, ID
National Provider Identifier
1194909598
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA-199 Issued in ID
Practice address
496 Shoup Ave W
Suite #E
Twin Falls, ID 83301-5043
Phone
(208) 733-2885
Fax
(208) 734-3352
NPI assigned
Dec 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA-199 ID Primary

Addresses

Primary practice location

496 Shoup Ave W
Suite #E
Twin Falls, ID 83301-5043

Mailing address

496 Shoup Ave W
Suite #E
Twin Falls, ID 83301-5043
Phone (120) 873-4590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-199IDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Idaho Pain Institute P.C. Past Accepting new patients
Sara L. Johnson, MD Past Accepting new patients
Miles H. Humphrey, M.D. Past Accepting new patients
Gem State Family Health Care PLLC PastSince Jul 7, 2018 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225929600000",
    "number": "1194909598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SHOUP AVE W",
            "address_2": "SUITE #E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015043",
            "telephone_number": "120-873-4590",
            "fax_number": "208-734-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SHOUP AVE W",
            "address_2": "SUITE #E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015043",
            "telephone_number": "208-733-2885",
            "fax_number": "208-734-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASCH",
        "first_name": "GLADYS",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-20",
        "last_updated": "2008-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.