NPIMap

Organization Active NPI

Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
National Provider Identifier
1255028221
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY HEALTH SERVICES CORPORATION
Practice address
2647 Kimberly Rd
Twin Falls, ID 83301-7976
Phone
(208) 650-7857
Fax
(208) 933-4453
NPI assigned
Apr 20, 2023
Last updated
Jun 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Authorized official

Name
Stacey Blackwood
Title
Credentialing Specialist
Phone
(208) 737-6718

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Psychologist 103T00000X NU
Social Worker 104100000X NU
Marriage & Family Therapist 106H00000X NU
Family Medicine Physician 207Q00000X NU
Case Management Agency 251B00000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Community/Behavioral Health Agency 251S00000X NU
Peer Specialist 175T00000X NU

Addresses

Primary practice location

2647 Kimberly Rd
Twin Falls, ID 83301-7976

Mailing address

794 Eastland Dr
Twin Falls, ID 83301-6856
Phone (208) 734-3312

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040216000531 ID Part B Supplier - Clinic/Group Practice 7012815038 Receives reassigned benefits from 77 practitioners
35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kimberly, ID; Rupert, ID; Shoshone, ID; Twin Falls, ID; Bellevue, ID; Buhl, ID; Burley, ID; Declo, ID…
O20240521002557 ID Part A Provider - Federally Qualified Health Center (FQHC) 7012815038 Practice locations: Twin Falls, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255028221. Details of each certification follow.

Federally qualified health center certification: CCN 131043

Legal name
FAMILY HEALTH SERVICES CORPORATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 19, 2024
Last certification
Apr 19, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 22, 1982 in ID
Enrollment address
2647 Kimberly Rd
Ste 2
Twin Falls, ID 83301-7976

Other NPIs on the same Medicare enrollment 35

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

View all 35

National Provider Directory

National Provider Directory
Tax ID family
Family Health Serv34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Aaron J Houston Individual Corporate OfficerCeo Feb 26, 2013 100%
W-2 Managing EmployeeCeo Feb 2, 2016 100%
Chris Wingfield Individual Corporate OfficerCio Mar 1, 1999
Melody Lefler Individual Corporate DirectorBoard Member - President Feb 1, 2008
Jane Miller Individual Corporate DirectorBoard Member May 1, 2018
Marta Hernandez Individual Corporate DirectorBoard Member Dec 1, 1999
Bonnie Hoag Individual Corporate DirectorBoard Member - Vice President Mar 1, 2011
Family Health Services Corporation Organization, Twin Falls, ID Corporation, Non-profit Operational/Managerial Control Apr 8, 2024 100%
Janet K King Individual Corporate DirectorBoard Member Nov 15, 2015
Robert Bulkley Individual Corporate DirectorBoard Member Mar 17, 2017
John Lothspeich Individual Corporate DirectorBoard Member Jan 25, 2022

All facility ownership & control disclosures 20

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Family Health ServicesTwin Falls, ID, CCN 131875 Federally qualified health center Operational/Managerial Control (100%) Feb 22, 1982
Family Health Services ShoshoneShoshone, ID, CCN 131894 Federally qualified health center Operational/Managerial Control (100%) Feb 22, 1982
Family Health Services CorporationTwin Falls, ID, CCN 131011 Federally qualified health center Operational/Managerial Control (100%) May 15, 2020
Family Health Services CorporationTwin Falls, ID, CCN 131017 Federally qualified health center Operational/Managerial Control (100%) May 15, 2020
Family Health Services CorporationJerome, ID, CCN 131016 Federally qualified health center Operational/Managerial Control (100%) Oct 25, 2022
Family Health Services CorporationTwin Falls, ID, CCN 131014 Federally qualified health center Operational/Managerial Control (100%) May 20, 2020
Family Health Services CorporationShoshone, ID, CCN 131019 Federally qualified health center Operational/Managerial Control (100%) Aug 5, 2021
Family Health Services CorporationTwin Falls, ID, CCN 131020 Federally qualified health center Operational/Managerial Control (100%) Jul 30, 2021
Family Health Services CorporationDeclo, ID, CCN 131023 Federally qualified health center Operational/Managerial Control (100%) May 21, 2021
Family Health Services CorporationBurley, ID, CCN 131024 Federally qualified health center Operational/Managerial Control (100%) Jun 12, 2019
Family Health Services CorporationBurley, ID, CCN 131026 Federally qualified health center Operational/Managerial Control (100%) Jun 29, 2020
Family Health Services CorporationBuhl, ID, CCN 131028 Federally qualified health center Operational/Managerial Control (100%) Aug 2, 2022
Family Health Services CorporationBuhl, ID, CCN 131027 Federally qualified health center Operational/Managerial Control (100%) Apr 12, 2022
Family Health Services CorporationJerome, ID, CCN 131031 Federally qualified health center Operational/Managerial Control (100%) Apr 1, 2023
Family Health Services CorporationKimberly, ID, CCN 131038 Federally qualified health center Operational/Managerial Control (100%) Aug 4, 2021
Family Health Services CorporationKimberly, ID, CCN 131037 Federally qualified health center Operational/Managerial Control (100%) Aug 4, 2021
Family Health Services CorporationTwin Falls, ID, CCN 131040 Federally qualified health center Operational/Managerial Control (100%) Oct 25, 2023
Family Health Services CorporationTwin Falls, ID, CCN 131046 Federally qualified health center Operational/Managerial Control (100%) Oct 22, 2024
Family Health ServicesKimberly, ID, CCN 131050 Federally qualified health center Operational/Managerial Control (100%) Jun 14, 1982
Family Health Services CorporationKimberly, ID, CCN 131052 Federally qualified health center Operational/Managerial Control (100%) Jun 14, 1982

Facilities with the same owner 20

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 20

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1255028221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "794 EASTLAND DR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016856",
            "telephone_number": "208-734-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2647 KIMBERLY RD",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833017976",
            "telephone_number": "208-650-7857",
            "fax_number": "208-933-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH SERVICES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-20",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "BLACKWOOD",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "208-737-6718"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.