Gene D Branum, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

M-13897 Issued in ID

Practice address

180 1St St W
#301
Ketchum, ID 83340

Phone

(208) 726-3707

NPI assigned

Jun 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Gene D Branum PC

  • Surgery Physician
  • Ketchum, ID
  • NPI 1164937496

  ID, Surgery

  Medicare reassignment NPD Authorized official
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Burley, ID
  • NPI 1710156922

  ID

  Medicare reassignment NPD
• North Canyon Medical Center Inc.

  • Critical Access Hospital
  • Gooding, ID
  • NPI 1609046671

  ID

  Medicare reassignment NPD
• North Canyon Medical Center, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Gooding, ID
  • NPI 1275703241
  NPD
• North Canyon Medical Center, Inc.

  • Radiology Clinic/Center
  • Twin Falls, ID
  • NPI 1700641636
  NPD
• Ihc Health Services Inc

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1003255464
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1386640076",
    "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": "833403721",
            "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": "#301",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "83340",
            "telephone_number": "208-726-3707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2006 Health Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Harrisonburg",
            "state": "VA",
            "postal_code": "228018679",
            "country_code": "US",
            "telephone_number": "540-689-5800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANUM",
        "first_name": "GENE",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101230423",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "M-13897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386640076",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ID",
            "identifier": "1386640076",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa A Boley, LPCP
• Karen Bommentre, LMFT
• Boost Orthopedics and Sports Medicine Consulting
• Braden C. Comstock, DMD, PLLC
• Kenneth Brait, MD
• Teresa Brennan, R.D.
• Ashley Brown, PA-C
• Katherine Mary Buckley, MD
• Anthony Maisin Buoncristiani, M.D.
• Tracey L Busby, M.D.

• 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 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.