Falls Centre for Functional Medicine, PLLC.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

O-180 Issued in ID

Legal business name

FALLS CENTRE FOR FUNCTIONAL MEDICINE, PLLC.

Practice address

236 Martin St
Twin Falls, ID 83301-4542

Phone

(208) 733-4444

Fax

(208) 733-4456

NPI assigned

Nov 21, 2017

Last updated

Feb 14, 2018By 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

Geoffrey Neil Hicks, NP-CNPI 1467966671

Title

Provider

Phone

(208) 733-4444

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17021/brand/1/csg/1/fhir/r4

Practitioners 4

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.

• Geoffrey Neil Hicks, NP-C

  • Family Nurse Practitioner
  • Twin Falls, ID
  • NPI 1467966671
  Medicare reassignment Care Compare group NPD Authorized official
• Laurence V Hicks, D.O.

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1730283250
  Medicare reassignment Care Compare group NPD
• Larry Hicks

  • Physician Assistant
  • Twin Falls, ID
  • NPI 1669004412
  Medicare reassignment Care Compare group
• Troy Bishop, LCSW

  • Mental Health Counselor
  • Twin Falls, ID
  • NPI 1427123959
  NPD

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518566400000",
    "number": "1962916304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 MARTIN ST",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014542",
            "telephone_number": "208-733-4444",
            "fax_number": "208-733-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 MARTIN ST",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014542",
            "telephone_number": "208-733-4444",
            "fax_number": "208-733-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLS CENTRE FOR FUNCTIONAL MEDICINE, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-21",
        "last_updated": "2018-02-14",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "NEIL",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "208-733-4444",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-180",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "ID",
            "license": "O-180",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807183500",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730283250",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Edward Fabe, DDS
• Kathleen Fagerland, CNM
• Kimberly Ann Failes, MS LPC LAT
• Laura M Fall, MD
• Falls Avenue Immediate Care PA
• Falls Orthodontics PLLC
• Family and Adolescent Care of Twin Falls PA
• Family Footsteps, Inc.
• Family Health Services Corporation
• Family Health Services Corporation

• Family Medicine Physician in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.