Fall River Medical, Pllc
Fall River Medical, Pllc is a healthcare organization registered as Primary Care Clinic/Center in Rexburg, ID, holding Type 2 (organization) NPI 1457698987 since 2013. The authorized official on file is Austin Gillette, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1457698987 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Fall River Medical, Pllc |
| Practice address | 21 WINN DR, Rexburg, ID, 83440 |
| Phone | 2088815222 |
| Fax | 8774414715 |
| Enumeration date | 2013-01-03 |
| Last updated in NPPES | 2019-11-19 |
Authorized official
| Name | Austin Gillette |
|---|---|
| Title | Owner |
| Phone | 2088815222 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | Secondary | O-0518 | ID |
| 261QR1100X | Research Clinic/Center | Secondary | O-0518 | ID |
| 261QU0200X | Urgent Care Clinic/Center | Secondary | O-0518 | ID |
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 261QP2300X | Primary Care Clinic/Center | Primary | O-0518 | ID |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083810287 | Other | ID | NPI |
| 1972709103 | Other | ID | NPI |
Copy-ready billing details
Provider: Fall River Medical, Pllc NPI: 1457698987 Taxonomy: 261QP2300X (Primary Care Clinic/Center) Address: 21 WINN DR, Rexburg, ID, 83440
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1114957362 | Kelly Dustin | Individual | Family Medicine Physician | Rexburg, ID |
| 1083810287 | Austin Gillette | Individual | Family Medicine Physician | Rexburg, ID |
| 1861818734 | Joshua Gilgen | Individual | Physician Assistant | Rexburg, ID |
| 1740659010 | Brennen Larsen | Individual | Physician Assistant | Rexburg, ID |
| 1528623303 | Jeremiah Buehner | Individual | Physician Assistant | Rexburg, ID |
| 1457939563 | Shelby Nordmann | Individual | Family Medicine Physician | Rexburg, ID |
Verify this record
Cross-check NPI 1457698987 against the authoritative CMS record: view Fall River Medical, Pllc on the official NPPES registry .
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 or validate an NPI number.
Frequently asked questions
Who is the authorized official for Fall River Medical, Pllc?
What is the NPI number for Fall River Medical, Pllc?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2019-11-19.