Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Henrys Fork Surgery Center Pllc

Ambulatory Surgical Clinic/Center in Rexburg, ID · enumerated 2020 · authorized official Jeremy Johnson, Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1235768490

Verified

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Registry record

Entity type Organization (Type 2)

Legal business name Henrys Fork Surgery Center Pllc

Practice address 23 Sawtelle Ave, Rexburg, ID, 83440

Phone (208) 359-1888

Fax (208) 359-1889

Enumeration date Apr 8, 2020

Last updated in NPPES Jun 19, 2025

Taxonomy & classification

261QA1903X Ambulatory Surgical Clinic/Center Ambulatory Health Care Facilities Primary

Authorized official

Name Jeremy Johnson

Title Manager

Phone (208) 359-1888

Other identifiers

Identifier	Type	State	Issuer
1447301395	Medicaid	ID	—

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is a Type 2 NPI?

A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

What type of organization is Henrys Fork Surgery Center Pllc?

Henrys Fork Surgery Center Pllc is registered in NPPES as a Ambulatory Surgical Clinic/Center (its primary provider taxonomy).

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-06-19.