NPI age
18 years
Enumerated 2008-04-15
● Active Type 2 · Organization
Subpart
Minidoka Memorial Hospital Ambulance
Minidoka Memorial Hospital Ambulance is 1 of 80 ambulance organizations in Idaho.
Primary specialty
Ambulance
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Hansen
Administrator
Last NPPES update
2011-06-07
Source: monthly bulk 2026-05
How this organization compares
Across 80 active ambulance providers in Idaho.
NPI age
18 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2008 → 2026
2008-04Enumerated in NPPES
2008
2026
Where they practice
Primary practice location
1224 8th St
Rupert, ID 833501527
Mailing address
1224 8th St
Rupert, ID 833501527
Authorized official
Carl Hansen
Administrator
📞 2084360481
Individual providers at this organization
15 individual providers on file at this primary practice address.
- Jessica Bagby, MD Emergency Medicine NPI 1093161473
- Jeffery Baldwin, P.T. Physical Therapist NPI 1205855202
- Scott Bloxham, P.T. Physical Therapist NPI 1962488205
- Charles Clair, MD Family Medicine NPI 1003012204
- Rachel Durrant, MS, CCC-SLP Speech-Language Pathologist NPI 1215432984
- Benjamin Guercio, CRNA Nurse Anesthetist, Certified Registered NPI 1972763381
- Maria Hernandez, P.T. Physical Therapist NPI 1730104597
- Lori Johnson, R.D.,L.D Dietitian, Registered NPI 1669578472
- Donald Konrad, D.O. Family Medicine NPI 1306836077
- Brandon Madsen, CRNA Nurse Anesthetist, Certified Registered NPI 1265037741
- Davee Mussmann, DPT Physical Therapist NPI 1144202938
- William Robar, DO Emergency Medicine NPI 1225560444
- Allison Serr, FNP-C Nurse Practitioner NPI 1144933912
- David Wageman, DO Emergency Medicine NPI 1528108867
- David Ward, PHARMD Pharmacist NPI 1851477863
Specialties
-
Ambulance PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 7808 | BLUE SHIELD OF IDAHO |
| 01 | E0922 | BLUE CROSS OF IDAHO |
| 05 (ID) | M0023360 |
Practice context
Multi-provider organization. 15 individual providers on file at this primary address.
Subpart of Minidoka Memorial Hospital.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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