NPIMap

Individual provider Active NPI

David J Brown, MD

  • Surgery Physician
  • Meridian, ID
National Provider Identifier
1184652364
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
M9567 Issued in ID
Practice address
2960 E. St. Luke's St.
Suite 200
Meridian, ID 83642-9005
Phone
(208) 378-4264
Fax
(208) 957-6891
NPI assigned
Jun 28, 2006
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X M9567 ID Primary
Obesity Medicine (Preventive Medicine) Physician 2083B0002X M-9567 ID

Addresses

Primary practice location

2960 E. St. Luke's St.
Suite 200
Meridian, ID 83642-9005

Mailing address

2960 E. St. Luke's St.
Suite 200
Meridian, ID 83642-9005
Phone (208) 378-4264

Other identifiers 1

IdentifierTypeStateIssuer
M9567OtherIDSTATE LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060912000415 ID Practitioner - General Surgery 2769486471

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of California, Davis School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3875 E Overland Rd
Suite 1C
Meridian, ID 83642-9005

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-9567IDMDObesity Medicine (Preventive Medicine) Physician
M9567IDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho Bariatric and Metabolic Institute L.L.C. Obesity Medicine CurrentSince May 1, 2019 Accepting new patients
Everest Anesthesia LLC PastSince Nov 9, 2021 Accepting new patients
Everest ASC Surgery PastSince Oct 1, 2021 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

6140 W Curtisian Ave
Ste 400
Boise, ID 83704
Phone (208) 327-5600

2960 E St Lukes St Ste 200
Ste 200
Meridian, ID 83642
Phone (208) 378-4264

2960 E St Lukes St Ste 200
Ste 200
Meridian, ID 83642
Phone (208) 378-4264

3875 E Overland Rd
Ste 1C
Meridian, ID 83642
Phone (208) 378-4264

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1184652364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 E. ST. LUKE'S ST.",
            "address_2": "SUITE 200",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429005",
            "telephone_number": "208-378-4264",
            "fax_number": "208-957-6891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 E. ST. LUKE'S ST.",
            "address_2": "SUITE 200",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429005",
            "telephone_number": "208-378-4264",
            "fax_number": "208-957-6891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "M9567",
            "primary": true
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "ID",
            "license": "M-9567",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "M9567",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.