OrganizationActive
Madison Co Memorial Hospital
NPI 1134592017 · Family Medicine Physician · Rexburg, ID
Provider details
- NPI number
- 1134592017
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Madison Co Memorial Hospital
- Organization subpart
- Yes
- Authorized official
- Rachel Gonzales, Chief Executive Officer(208) 359-6900
- License
- 40 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
393 E 2nd N
Rexburg, ID 83440-1605
Phone: (208) 356-5401
Fax: (208) 356-3111
Street-level locationGet directions
Mailing address
393 E 2nd N
Rexburg, ID 83440-1605
Other names (DBA / former)
- Doing business as
- Madison Memorial Rexburg Medical Clinic
- Doing business as
- Madison Memorial Rexburg Medical Clinic
Registry dates
- Enumerated
- 2015-11-02
- Last updated
- 2023-10-23
- Certified
- 2023-10-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.