Brian C Birch, MD
Individual provider Active NPI Pediatrics Physician · Meridian, ID
NPI 1194042713 · NPPES record last updated Jun 6, 2023
Key facts
- NPI
- 1194042713
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- M-12019 (ID)
- Practice address
- 2921 S Meridian Rd
Meridian, ID 83642-7961 - Phone
- (208) 297-7847
- Fax
- (208) 203-0097
- NPI assigned
- Apr 21, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-12019 | ID | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Treasure Valley Childrens Clinic, PC | Pediatrics | Current | Accepting new patients |
| St Lukes Regional Medical Center | Past | Accepting new patients | |
| St Luke'S Magic Valley Regional Medical Center LTD | Past | Accepting new patients |
Locations
1775 W State St
Boise, ID 83702
Phone (208) 576-6279
2921 S Meridian Rd
Meridian, ID 83642
Phone (208) 297-7847
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | M-12019 | ID | Yes |
Addresses
Primary practice location
2921 S Meridian Rd
Meridian, ID 83642-7961
Mailing address
1775 W State St # 229
Boise, ID 83702-3924
Phone (208) 297-7847
Other providers in Meridian, ID
- Morgan Biggs
- Angela Christine Billingsley
- Montrice Billingsley
- Eva Bingham
- Biofourmis Care FL PLLC
- Tyler T Birch
- Birchwood Dental, PLLC
- Marlene Bird
- Renae Marie Birkby
- Ashley Elizabeth Birkland
All providers in Meridian, ID · Pediatrics Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.