NPIMap

Organization Active NPI

Madison Co Memorial Hospital

  • General Acute Care Hospital
  • Rexburg, ID
National Provider Identifier
1992747570
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 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
Last updated
Feb 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 40 ID
General Acute Care Hospital 282N00000X Primary

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 names 1

  • Madison Memorial Hospital Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1992747570. Details of each certification follow.

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
OtherNon-profit
Enrollment address
450 E Main St
Rexburg, ID 83440-2048
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Hospital certification: CCN 13S025

Legal name
MADISON CO MEMORIAL HOSPITAL
Doing business as
MADISON MEMORIAL HOSPITAL
Organization structure
OtherProprietary
Enrollment address
450 E Main St
Rexburg, ID 83440-2048
Other Hospital Practice Location
Hospital subgroups
Acute care, Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Madison Memorial HospitalCCN 130025 · All quality measures
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

2235 E 25th St
Idaho Falls, ID 83404
Phone (208) 243-9152

381 E 4th N
Rexburg, ID 83440
Phone (208) 359-2300

Interoperability endpoints

  • Direct secure messaging: analee.fish@direct.madisonmemorial.org
  • Direct secure messaging: bbeesley@direct.madisonmemorial.org
  • Direct secure messaging: blanchle@direct.madisonmemorial.org
  • Direct secure messaging: brunsoza@direct.madisonmemorial.org
  • Direct secure messaging: ccodd@direct.madisonmemorial.org
  • Direct secure messaging: clarkjac@direct.madisonmemorial.org
  • Direct secure messaging: curtisja@direct.madisonmemorial.org
  • Direct secure messaging: eysserma@direct.madisonmemorial.org
  • Direct secure messaging: ggates@direct.madisonmemorial.org
  • Direct secure messaging: gouldile@direct.madisonmemorial.org
  • Direct secure messaging: haleje@direct.madisonmemorial.org
  • Direct secure messaging: hansenbr@direct.madisonmemorial.org
  • Direct secure messaging: hansontr@direct.madisonmemorial.org
  • Direct secure messaging: hardysc@direct.madisonmemorial.org
  • Direct secure messaging: jensenja@direct.madisonmemorial.org
  • Direct secure messaging: jensenst@direct.madisonmemorial.org
  • Direct secure messaging: jhymas@direct.madisonmemorial.org
  • Direct secure messaging: larsenbr@direct.madisonmemorial.org
  • Direct secure messaging: lwebster@direct.madisonmemorial.org
  • Direct secure messaging: manganma@direct.madisonmemorial.org

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Marshall Merrell Individual Other Apr 13, 2006
Holly Forbush Individual Other Jan 22, 2015
Rachel Gonzales Individual Corporate OfficerCeo Jun 25, 2008
Jerry Rigby Individual Other Apr 18, 2011
Joseph Troy Christensen Individual Corporate OfficerCfo Aug 1, 2013
W-2 Managing EmployeeCfo Aug 1, 2013
Maurie Barton Individual Other Apr 18, 2011
Ken Burt Individual Other Jun 30, 1999
Scott Dixon Individual Other Sep 4, 2012
Taunia Berrett Individual W-2 Managing Employee Jan 1, 2011
Neil Erickson Individual Other Apr 18, 2011
Dan Kettle Individual Other Jan 24, 2018
Madison Co Memorial Hospital Organization, Rexburg, ID Other Jul 1, 1966

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Madison Memorial HospitalRexburg, ID, CCN 13S025 Hospital Other Jul 1, 1966
Madison Carriage Cove Short Term RehabilitationRexburg, ID, CCN 135140 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

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Subparts reporting this organization as parent 11

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 47

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.

View all 47

Affiliated clinicians 180

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 180

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1992747570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E MAIN ST",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402048",
            "telephone_number": "208-359-6900",
            "fax_number": "208-359-9879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E. MAIN",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "83440",
            "telephone_number": "208-359-6900",
            "fax_number": "208-359-9879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON CO MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "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": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "ID",
            "license": "40",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison Memorial Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rexburg, ID

Sources for this page

Verify at the official NPI Registry.