NPIMap

Organization Active NPI

Madison Co Memorial Hospital

Doing business as Madison Foot and Ankle

  • Podiatrist
  • Rexburg, ID
National Provider Identifier
1730800897
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
MADISON CO MEMORIAL HOSPITAL
Doing business as
Madison Foot and Ankle
Practice address
25 Madison Professional Park
Rexburg, ID 83440-2057
Phone
(208) 359-1400
NPI assigned
Sep 7, 2022
Last updated
Mar 5, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MADISON C O MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Authorized official

Name
Rachel Gonzales, DM, RN, RODP
Title
Chief Executive Officer
Phone
(208) 359-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X Primary

Addresses

Primary practice location

25 Madison Professional Park
Rexburg, ID 83440-2057

Mailing address

PO Box 700
Rexburg, ID 83440-0700
Phone (208) 359-6516

Other practice location 1

477 Pleasant Country Ln
Rigby, ID 83442-5278
Phone (208) 359-9840

Other names 1

  • Madison Foot and Ankle Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000664 ID Part B Supplier - Clinic/Group Practice 8123016367 Receives reassigned benefits from 45 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rexburg, ID; Rigby, ID

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Madison Hospital6 organizations share this tax ID, including this one
Part of
Madison Hospital

Other organizations with this tax ID 5

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

25 Madison Professional Park
Rexburg, ID 83440
Phone (208) 359-1400

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1730800897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 700",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834400700",
            "telephone_number": "208-359-6516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MADISON PROFESSIONAL PARK",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402057",
            "telephone_number": "208-359-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "477 Pleasant Country Ln",
            "address_purpose": "LOCATION",
            "city": "Rigby",
            "state": "ID",
            "postal_code": "834425278",
            "country_code": "US",
            "telephone_number": "208-359-9840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MADISON CO MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MADISON C O MEMORIAL HOSPITAL",
        "enumeration_date": "2022-09-07",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "208-359-6900",
        "authorized_official_credential": "DM, RN, RODP"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Madison Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.