Madison Co Memorial Hospital
Organization Active NPI General Acute Care Hospital · Rexburg, ID
NPI 1992747570 · NPPES record last updated Feb 2, 2026
Key facts
- NPI
- 1992747570
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- Legal business name
- MADISON CO MEMORIAL HOSPITAL
- Practice address
- 450 E. Main
Rexburg, ID 83440 - Phone
- (208) 359-6900
- Fax
- (208) 359-9879
- NPI assigned
- Jun 11, 2006
- Organization subpart
- No
Authorized official
- Name
- Rachel Gonzales, DM, RN, RODP
- Title
- Chief Executive Officer
- Phone
- (208) 359-6900
Owners & managing parties with NPI records 3
-
Marshall H Merrell, O.D.
Owned or controlled facilities with NPI records 2
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 2
Subparts reporting this organization as parent 10
Related certifications (CCN) 2
Practitioners 62
-
Brian Paul Beesley, M.D.
-
Zachery M Brunson, PA-C
-
Jack O. Clark, M.D.
-
Matheau Eysser, D.O.
-
Scott Russell Hardy, D.O.
-
Marie Horne, CNM
-
Martin A Mangan, DO
-
James McCoy, MD
-
Rex Allen Meredith, PA-C
-
James Morris, MD
-
Michael M Packer, M.D.
-
Corey T Rammell, MD
-
Joseph Watson, MD
-
Linda R Webster, NP
-
Travis J Weiszhaar, P.A.-C.
-
Eric E. Barton, DPM
-
Erin Joanne Benson, NP-C
-
Colby Ray Brower, MD
-
Zackery J Cleverley, PA-C
-
Hayley Brooke Grover, FNP-C
-
Michael J Larson, MD
Affiliated clinicians 180
-
David Paul Adams, FNP-C
-
William D Adams, DO
-
Travis Lee Allen, PA-C
-
Matthew Hardy Allred, D.O.
-
Michael Anderson, D.O.
-
Bryce L Arnold, D.O.
-
Eric E. Barton, DPM
-
Jed Terrell Bartschi, PA-C
-
Brian Paul Beesley, M.D.
-
Clint E Behrend, M.D.
-
Erin Joanne Benson, NP-C
-
Colby Bingham, M.D.
-
Mel Bingham, PA-C
-
Melissa Marie Black, FNP-C
-
Adam Robert Blakeman, PA-C
-
Douglas U. Blank, MD
-
Richard Alan Blatter, D.O.
-
Andrew Logan Brower, PA-C
-
John D Chambers Jr., M.D.
-
Brian Wade Christensen, M.D.
-
Jack O. Clark, M.D.
-
Zackery J Cleverley, PA-C
Medicare Care Compare: Hospital
- Listed as
- Madison Memorial Hospital
- Type
- Acute Care Hospitals
- Ownership
- Government - Local
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ID
Hospital certification: CCN 130025
- Legal name
- MADISON CO MEMORIAL HOSPITAL
- Doing business as
- MADISON MEMORIAL HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Jun 28, 2018
- Beds
- 81
- Ownership / control type
- Local
- Organization structure
- Other · Non-profit
- Enrollment address
- 450 E Main St
Rexburg, ID 83440-2048 - Hospital subgroups
- General, Acute care
Hospital certification: CCN 13S025
- Legal name
- MADISON CO MEMORIAL HOSPITAL
- Doing business as
- MADISON MEMORIAL HOSPITAL
- Organization structure
- Other · Proprietary
- Enrollment address
- 450 E Main St
Rexburg, ID 83440-2048 - Hospital subgroups
- Acute care, Psychiatric unit
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Marshall Merrell |
Other | Apr 13, 2006 | |
| Holly Forbush |
Other | Jan 22, 2015 | |
| Rachel Gonzales |
Corporate Officer |
Jun 25, 2008 | |
| Jerry Rigby |
Other | Apr 18, 2011 | |
| Joseph Troy Christensen |
Corporate Officer |
Aug 1, 2013 | |
| W-2 Managing Employee |
Aug 1, 2013 | ||
| Maurie Barton |
Other | Apr 18, 2011 | |
| Ken Burt |
Other | Jun 30, 1999 | |
| Scott Dixon |
Other | Sep 4, 2012 | |
| Taunia Berrett |
W-2 Managing Employee | Jan 1, 2011 | |
| Neil Erickson |
Other | Apr 18, 2011 | |
| Dan Kettle |
Other | Jan 24, 2018 | |
| Madison Co Memorial Hospital |
Other | Jul 1, 1966 |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Madison Memorial Hospital |
Hospital | Other | Jul 1, 1966 |
| Madison Carriage Cove Short Term Rehabilitation |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (50%) General Partnership Interest (50%) Operational/Managerial Control Adp of the SNF Direct Ownership Interest (50%) |
Oct 1, 2017 Oct 1, 2017 Oct 1, 2017 Oct 1, 2017 Oct 1, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050707000644 | ID | Part a Provider - Hospital | 8123016367 |
1 other NPI on this enrollment Practice locations: Rexburg, ID |
| O20210728003542 | ID | Part a Provider - Hospital | 8123016367 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Rexburg, ID |
National Provider Directory
Locations
381 E 4th N
Rexburg, ID 83440
Phone (208) 359-2300
Interoperability endpoints
- hansenbr@direct.madisonmemorial.org
- hardysc@direct.madisonmemorial.org
- thompsju@direct.madisonmemorial.org
- tweiszhaar@direct.madisonmemorial.org
- wanfalda@direct.madisonmemorial.org
- curtisja@direct.madisonmemorial.org
- slofgran@direct.madisonmemorial.org
- rmeredith@direct.madisonmemorial.org
- jensenja@direct.madisonmemorial.org
- snarrpa@direct.madisonmemorial.org
- wellsed@direct.madisonmemorial.org
- rameredith@direct.madisonmemorial.org
- ggates@direct.madisonmemorial.org
- morrisja@direct.madisonmemorial.org
- analee.fish@direct.madisonmemorial.org
- clarkjac@direct.madisonmemorial.org
- eysserma@direct.madisonmemorial.org
- blanchle@direct.madisonmemorial.org
- mooretyl@direct.madisonmemorial.org
- hansontr@direct.madisonmemorial.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 40 | ID | |
| General Acute Care Hospital | 282N00000X | Yes |
Addresses
Primary practice location
450 E. Main
Rexburg, ID 83440
Mailing address
450 E Main St
Rexburg, ID 83440-2048
Phone (208) 359-6900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00109 | Other | ID | BLUE CROSS OF IDAHO |
| 002855700 | Medicaid | ID | |
| 2855700 | Medicaid | ID | |
| 000010006291 | Other | ID | REGENCE BLUE SHIELD OF ID |
Other names
- Madison Memorial Hospital
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All providers in Rexburg, ID · General Acute Care Hospital in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.