Active NPI
Kenneth Jenson Bramwell, MD
- Emergency Medicine Physician
- Boise, ID
National Provider Identifier
1124065214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- M8736
- Practice address
- 190 E Bannock St
Boise, ID 83712-6241 - Phone
- (208) 381-2222
- NPI assigned
- May 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Emergency Medicine) Physician | 207PP0204X | M8736 | ID | |
| Emergency Medicine Physician | 207P00000X | M8736 | ID | Primary |
Addresses
Primary practice location
190 E Bannock St
Boise, ID 83712-6241
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 87.3 of 100
- Quality
- 81.29
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.37
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M8736 | ID | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Current | Accepting new patients | |
| Department of Pediatrics University of Utah | Past | Accepting new patients | |
| Pediatric Emergency Medicine Department of University of Utah | Past | Accepting new patients | |
| Utah Emergency Physicians | Emergency Medicine | Past | Accepting new patients |
| University of Utah Emergency Physicians | Past | Accepting new patients | |
| University of Utah Emergency Physicians | Emergency Medicine | Past | Accepting new patients |
Locations
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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-
- Pediatrics Physician
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- NPI 1679528715
-
- Pediatric Emergency Medicine (Pediatrics) Physician
- Salt Lake City, UT
- NPI 1275570665
-
- Emergency Medical Services (Emergency Medicine) Physician
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- NPI 1093769218
-
- Emergency Medicine Physician
- Rock Springs, WY
- NPI 1730583295
-
- Emergency Medicine Physician
- Salt Lake City, UT
- NPI 1588048979
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600732800000",
"number": "1124065214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-381-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-381-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAMWELL",
"first_name": "KENNETH",
"middle_name": "JENSON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-31",
"last_updated": "2020-09-22",
"certification_date": "2020-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "207PP0204X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Pediatric Emergency Medicine",
"state": "ID",
"license": "M8736",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "ID",
"license": "M8736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.