Individual provider Active NPI

Adam Grant Hodges, DDS

  • General Practice Dentistry
  • Twin Falls, ID
National Provider Identifier
1629035258
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-3811 Issued in ID
Practice address
794 Eastland Dr
Twin Falls, ID 83301-6856
Phone
(208) 734-3312
Fax
(208) 734-5036
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D-3811 ID Primary

Addresses

Primary practice location

794 Eastland Dr
Twin Falls, ID 83301-6856

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
8071147MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160914002579 ID Order and Referring Only - DentistPractitioner - Dentist 1153617337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Services Corporation Past Accepting new patients
Family Health Services Corporation Past Accepting new patients
Family Health Services Corporation General Practice Past Accepting new patients
Family Health Services Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: adam.hodges.p1@direct.fhsid.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1629035258",
    "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": "794 EASTLAND DR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016856",
            "telephone_number": "208-734-3312",
            "fax_number": "208-734-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "ADAM",
        "middle_name": "GRANT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8071147",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.