Gene D Branum PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

M-13897 Issued in ID

Legal business name

GENE D BRANUM PC

Practice address

180 1St St W
Ste 301
Ketchum, ID 83340-0180

Phone

(208) 726-3707

Fax

(208) 726-4817

NPI assigned

Dec 8, 2017

Last updated

Jun 5, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gene Dale Branum, MDNPI 1386640076

Title

Owner

Phone

(208) 726-3707

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gene D Branum, MD

  • Surgery Physician
  • Ketchum, ID
  • NPI 1386640076
  Medicare reassignment NPD Authorized official
• Ralph P Campanale II, M.D.

  • Surgery Physician
  • Ketchum, ID
  • NPI 1972566727
  NPD (past)

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591315200000",
    "number": "1164937496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3778",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "833403778",
            "telephone_number": "208-726-3707",
            "fax_number": "208-726-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 1ST ST W",
            "address_2": "STE 301",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "833400180",
            "telephone_number": "208-726-3707",
            "fax_number": "208-726-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENE D BRANUM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-08",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A",
        "authorized_official_last_name": "BRANUM",
        "authorized_official_first_name": "GENE",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-726-3707",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "M-13897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Lynn Finnegan, PT
• Mary Kay Hausladen Foley, PT
• Nanette Cornish Ford, PA C
• Benjamin Robert Franz, D.D.S.
• Brian Cameron Galbraith, DDS
• Gerald R Moress MD PC
• Rebecca Grace, PSY.D.
• Abram Joseph Guard, PHARMD
• Kathleen Egan Haisley, MD
• Rio Hale

• Surgery Physician in Ketchum, ID
• Providers in Ketchum, ID by specialty
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.