FALL RIVER MEDICAL, PLLC
NPI 1457698987
Clinic/Center - Primary Care in Rexburg, ID
NPI Status: Active since January 03, 2013
Contact Information
21 WINN DR
REXBURG, ID
ZIP 83440
Phone: (208) 881-5222
Fax: (877) 441-4715
- Organization
- Clinic/Center
- Primary Care
- Accepts Insurance
- CLIA Number: 13D2074775
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 03-17-2027
About FALL RIVER MEDICAL, PLLC
This page provides the complete NPI Profile along with additional information for Fall River Medical, Pllc, a primary care provider established in Rexburg, Idaho operating as a Clinic/center, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1457698987 assigned on January 2013. The practitioner's primary taxonomy code is 261QP2300X with license number O-0518 (ID). The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Dr. Austin C Gillette Md (Owner)
- NPI
- 1457698987
- Provider Name
- FALL RIVER MEDICAL, PLLC
- Entity Type
- Organization
- Location Address
- 21 WINN DR REXBURG, ID 83440
- Location Phone
- (208) 881-5222
- Location Fax
- (877) 441-4715
- Mailing Address
- 21 WINN DR REXBURG, ID 83440
- Mailing Phone
- (208) 220-1057
- Mailing Fax
- (877) 441-4715
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-03-2013
- Last Update Date
- 11-19-2019
- Code Navigator
A primary care provider (PCP) like Fall River Medical, Pllc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Primary Care
- Taxonomy Code
- 261QP2300X
- Type
- Ambulatory Health Care Facilities
- License No.
- O-0518
- License State
- ID
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | O-0518 (ID) |
| 2 | 261QR1100X | Ambulatory Health Care Facilities | Clinic/Center | O-0518 (ID) |
| 3 | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | O-0518 (ID) |
| 4 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Moda Select Alaska Bronze 6500 - PPO
- Moda Select Alaska Bronze HDHP 5500 - PPO
- Moda Select Alaska Gold 1500 - PPO
- Moda Select Alaska Silver 4500 - PPO
- Moda Select Alaska Standard Bronze - PPO
- Moda Select Alaska Standard Gold - PPO
- Moda Select Alaska Standard Silver - PPO
- Moda Select Texas Bronze 8700 ($0 Virtual Urgent Care through CirrusMD) - EPO
- Moda Select Texas Bronze HDHP 7500 - EPO
- Moda Select Texas Standard Bronze - EPO
- Moda Select Texas Standard Gold - EPO
- Moda Select Texas Standard Silver - EPO
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay Office Visits - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay Office Visits - EPO
- Healthy Premier Silver Standard - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1972709103 | OTHER (01) | ID | NPI |
| 1083810287 | OTHER (01) | ID | NPI |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 13D2074775
- Facility Type
- Physician Office
- Certificate Effective Date
- March 18, 2025
- Certificate Expiration Date
- March 17, 2027
- Laboratory Director
- AUSTIN C. GILLETTE
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Fall River Medical, Pllc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1457698987, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 73 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1457698987, enumerated as an "organization" on January 03, 2013.
The provider is located at 21 WINN DR REXBURG, ID 83440 and the phone number is (208) 881-5222.
Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.
The provider might be accepting Accepts: Moda Health Plan, Inc., University of Utah Health. Please consult your insurance carrier or call the provider to verify.
