Active NPI
Brek Pilling, PHD
- Psychologist
- Burley, ID
National Provider Identifier
1356543094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY202122
- Practice address
- 1918 Overland Ave
Burley, ID 83318-2439 - Phone
- (208) 219-0211
- Fax
- (208) 733-9463
- NPI assigned
- Jun 4, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY202122 | ID | Primary |
Addresses
Primary practice location
1918 Overland Ave
Burley, ID 83318-2439
Mailing address
PO Box 1657
Twin Falls, ID 83303-1657
Phone (208) 734-3356
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY202122 | ID | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356543094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1657",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833031657",
"telephone_number": "208-734-3356",
"fax_number": "208-733-9463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1918 OVERLAND AVE",
"city": "BURLEY",
"state": "ID",
"postal_code": "833182439",
"telephone_number": "208-219-0211",
"fax_number": "208-733-9463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PILLING",
"first_name": "BREK",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "ID",
"license": "PSY202122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burley, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.