Family Health Services Corporation

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

FAMILY HEALTH SERVICES CORPORATION

Practice address

401 W Camas Ave
Fairfield, ID 83327

Phone

(208) 764-2677

Fax

(208) 764-2646

NPI assigned

May 31, 2006

Last updated

Apr 30, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Aaron Houston

Title

Cfo

Phone

(208) 734-3312

Specialties & licenses 13

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316984529. Details of each certification follow.

• CCN 131826 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 131826

Legal name

FAMILY HEALTH SERVICES CORPORATION

Doing business as

FAMILY HEALTH SERVICES

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jan 13, 2005

Last certification

Jan 13, 2005

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Feb 22, 1982 in ID

Enrollment address

401W Camas Ave
Fairfield, ID 83327

Related CCNs

131804

Related certifications (CCN) 1

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

• Family Health Services Corporation

  dba Family Health Services

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1669449450

  Related provider number

  Provider of Services

Other NPIs on the same Medicare enrollment 35

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

• Family Health Services Corporation

  dba Family Health Services

  • Federally Qualified Health Center (FQHC)
  • Buhl, ID
  • NPI 1003862525

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Burley, ID
  • NPI 1033165550

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Jerome, ID
  • NPI 1073188728

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Rupert, ID
  • NPI 1093761694

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1124571815

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Kimberly, ID
  • NPI 1154089795

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  dba Family Health Services

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1194341388

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  dba Family Health Services

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1235279217

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Bellevue, ID
  • NPI 1245804400

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1255028221

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  dba Family Health Services

  • Federally Qualified Health Center (FQHC)
  • Declo, ID
  • NPI 1285297804

  O20040216000531

  Same enrollment
• Family Health Services Corporation

  dba Family Health Services

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1306462593

  O20040216000531

  Same enrollment

All disclosed owners & managing parties 8

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

All facility ownership & control disclosures 21

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

Practitioners 77

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.

• Basil Clarence Anderson, M.D.

  • Family Medicine Physician
  • Kimberly, ID
  • NPI 1518282110
  NPD
• Benjamin W Attebury, PA-C

  • Physician Assistant
  • Twin Falls, ID
  • NPI 1437345923
  NPD
• Jesse J Balls, PA-C

  • Medical Physician Assistant
  • Jerome, ID
  • NPI 1487026191
  NPD
• Alisa Barnes, PAC

  • Physician Assistant
  • Hailey, ID
  • NPI 1285797357
  NPD
• Randalyn Barrow, LCSW

  • Clinical Social Worker
  • Burley, ID
  • NPI 1174249957
  NPD
• Jameson Bastow, DO

  • Family Medicine Physician
  • Jerome, ID
  • NPI 1639791361
  NPD
• Tabatha Jo Baumgartner, LCSW

  • Clinical Social Worker
  • Rupert, ID
  • NPI 1225569338
  NPD
• Nicole Becker, PSY.D.

  • Psychologist
  • Twin Falls, ID
  • NPI 1497884498

  Mental Health

  NPD
• Jennifer Marie Benally, PMHNP-C

  • Family Nurse Practitioner
  • Twin Falls, ID
  • NPI 1720513682

  Family Medicine

  NPD
• Abelardo Benitez

  • Physician Assistant
  • Twin Falls, ID
  • NPI 1093491706

  Family Medicine

  NPD
• Mathew G Bowden, CSW

  • Clinical Social Worker
  • Burley, ID
  • NPI 1215194121
  NPD
• Nicolas A Bregante, PA-C

  • Medical Physician Assistant
  • Buhl, ID
  • NPI 1538485180
  NPD

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1316984529",
    "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",
            "fax_number": "208-734-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W CAMAS AVE",
            "city": "FAIRFIELD",
            "state": "ID",
            "postal_code": "83327",
            "telephone_number": "208-764-2677",
            "fax_number": "208-764-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH SERVICES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "HOUSTON",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "208-734-3312",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "ID",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002547002",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camas County School District #121
• County of Camas (Camas County Ambulance Service)
• Family Health Services Corporation (Family Health Services Fairfield Pharmacy)
• Garold H Horn, RDH
• Julie A Marosi, RN
• Brittni McLam, DO
• Dean William Rodemack, PA-C

• Federally Qualified Health Center (FQHC) in Fairfield, ID
• Providers in Fairfield, ID by specialty
• Federally Qualified Health Center (FQHC) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.