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NORTH FORK SURGERY CENTER
NPI 1831134584
Clinic/Center - Ambulatory Surgical in Rexburg, ID

Active since June 17, 2006
381 EAST 4TH NORTH, SUITE 200, REXBURG, ID 83440(208) 359-2300 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About North Fork Surgery Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTH FORK SURGERY CENTER (NPI 1831134584) is a healthcare organization registered as an ambulatory surgical in Rexburg, Idaho and active in the NPI registry since June 2006. The organization lists Dwayne M Hansen, Board Chairman, as its authorized official.

NPPES Registry Identity

NPI1831134584
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameREXBURG SURGERY CENTER LLC
Location Address381 EAST 4TH NORTH, SUITE 200Rexburg, ID 83440
Mailing Address381 East 4th North, Suite 200Rexburg, ID 83440 · (208) 359-2300
Phone(208) 359-2300
Organization SubpartNo
Authorized OfficialDwayne M HansenBoard Chairman · (208) 359-2300
Enumeration DateJune 17, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1831134584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
381 EAST 4TH NORTH, Rexburg, ID 83440
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Other Names 1

Doing Business AsNorth Fork Surgery Center

Other Identifiers 3

Other04870ID · Blue Cross Provider Numbe
Medicaid80760000ID
Other000010158869ID · Blue Shield Provider Numb

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DWAYNE M HANSEN M.D.
Surgery
381 EAST 4TH NORTH, STE 100
REXBURG, ID 83440
Madison County (208) 656-8442

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rexburg Surgery Center LLC's NPI number?

The NPI number for Rexburg Surgery Center LLC is 1831134584. It was assigned to this organization in the NPPES registry on June 17, 2006. The provider is doing business as North Fork Surgery Center.

Where is Rexburg Surgery Center LLC located?

Rexburg Surgery Center LLC is located at 381 East 4th North Suite 200, Rexburg, ID 83440. The listed phone number is (208) 359-2300.

What is Rexburg Surgery Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

When was this NPI record last updated?

The NPPES record for Rexburg Surgery Center LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.