Individual provider Active NPI

Scott Brunson, MD

  • Emergency Medicine Physician
  • Boise, ID
National Provider Identifier
1174941660
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M-14638 Issued in ID
Practice address
500 W Fort St # 111
Boise, ID 83702-4501
Phone
(208) 422-1000
NPI assigned
Apr 1, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Q6156 TX
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X M-14638 ID Primary

Addresses

Primary practice location

500 W Fort St # 111
Boise, ID 83702-4501

Mailing address

500 W Fort St # 111
Boise, ID 83702-4599
Phone (208) 422-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160613001813 TX Practitioner - Emergency Medicine 2365732856 Reassigns benefits to 3 organizations
I20210111001932 ID Practitioner - Emergency Medicine 2365732856 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q6156TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mother Frances Hospital Regional Health Care Center CurrentSince Nov 1, 2020 Accepting new patients
Carepoint Health Emergency Medicine Idaho, PLLC Emergency Medicine CurrentSince Dec 16, 2020 Accepting new patients
Walter Knox Memorial Hospital Current Accepting new patients
Century Integrated Partners, Inc Emergency Medicine CurrentSince May 10, 2017 Accepting new patients
Mother Frances Hospital Jacksonville CurrentSince Nov 1, 2020 Accepting new patients

Locations

1717 Arlington Ave
Caldwell, ID 83605
Phone (208) 455-3719

1202 E Locust St
Emmett, ID 83617
Phone (208) 365-2338

3500 Gaston Ave
Dallas, TX 75246

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Interoperability endpoints

  • Direct secure messaging: sbrunson236292@christushealth.direct-ci.net
  • FHIR API: https://fhir-myrecord.cerner.com/r4/eb237299-e2be-4fd4-aca6-5fa7adcd28c1/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1174941660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W FORT ST # 111",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024599",
            "telephone_number": "208-422-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W FORT ST # 111",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024501",
            "telephone_number": "208-422-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSON",
        "first_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-01",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q6156",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M-14638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.