Dan S Fairman, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M4921 Issued in ID

Practice address

100 Hospital Drive
Ketchum, ID 83340

Phone

(208) 727-8888

NPI assigned

Jun 9, 2006

Last updated

Jan 30, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Saint Louis University School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Lukes Clinic - Wood River LLCGroup PAC ID 3173783818, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Home Care and Hospice Home health agency, Meridian, ID, CCN 137028
• Idaho Home Health & Hospice Home health agency, Twin Falls, ID, CCN 137014
• St Luke's Wood River Medical Center Hospital, Ketchum, ID, CCN 131323
• St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dfairman16835@direct.slhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Lukes Clinic - Wood River LLC

  • Internal Medicine Physician
  • Ketchum, ID
  • NPI 1972891604
  Medicare reassignment Care Compare group NPD
• Folsom Anesthesia Medical Group Inc.

  • Anesthesiology Physician
  • Folsom, CA
  • NPI 1295749620
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• LHCG Xvii, LLC

  dba Idaho Home Health & Hospice

  • Home Health Agency
  • Twin Falls, ID
  • NPI 1356669675
  Care Compare affiliation
• St Luke's Regional Medical Center

  dba St Lukes Home Care

  • Home Health Agency
  • Meridian, ID
  • NPI 1306945985
  Care Compare affiliation
• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation
• St Lukes Wood River Medical Center LTD

  dba St Lukes Wood River Medical Center

  • Critical Access Hospital
  • Ketchum, ID
  • NPI 1508869470
  Care Compare affiliation
• St. Luke's Magic Valley Regional Medical Center, LTD.

  dba St Lukes Magic Valley - Air Ambulance

  • General Acute Care Hospital
  • Twin Falls, ID
  • NPI 1932154705
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1023059250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "833400100",
            "telephone_number": "208-727-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DRIVE",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "83340",
            "telephone_number": "208-727-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRMAN",
        "first_name": "DAN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M4921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Williams Dunn
• Elevate Dental Hygiene LLC
• Cathryn Erickson, DO
• Kerri Everett, SLP
• Eyecenter PA (Ketchum Eyecenter)
• Family Medicine & Medicine
• Scott L Featherstone, DDS
• Madison Ferris, LPC
• Caitlin Ferry, M.S., CCC-SLP
• Frank L Fiaschetti, MD

• Internal Medicine Physician in Ketchum, ID
• Providers in Ketchum, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.