NPIMap

Individual provider Active NPI

Brenda S Davies, MD

  • Obstetrics & Gynecology Physician
  • Caldwell, ID
National Provider Identifier
1407826209
Registry record updated Aug 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G05134 Issued in ID
Practice address
315 E Elm St
Suite 310
Caldwell, ID 83605-4857
Phone
(208) 454-2035
Fax
(208) 454-1065
NPI assigned
Jan 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G05134 ID Primary

Addresses

Primary practice location

315 E Elm St
Suite 310
Caldwell, ID 83605-4857

Mailing address

3520 E. Louise Dr
Meridian, ID 83642
Phone (208) 955-0350

Other identifiers 4

IdentifierTypeStateIssuer
15024OtherIDBLUE CROSS OF IDAHO
207527MedicaidOR
000010001161OtherIDREGENCE BLUE SHIELD OF ID
003658200MedicaidID

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 Medicine

State licenses

LicenseStateTypeSpecialty
G05134IDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Valley Medical Group Specialty Services LLC PastSince Nov 12, 2019 Accepting new patients
Grays Harbor Womens Clinic PLLC Obstetrics & Gynecology Past Accepting new patients
Franciscan Medical Group Past Accepting new patients
T-Medica Mobil Anesthesia Inc. PastSince Apr 17, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bdavies17161@fhsce.catholichealth.net

Organizations & group practices 4

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249344000000",
    "number": "1407826209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 E. LOUISE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-955-0350",
            "fax_number": "208-955-0352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E ELM ST",
            "address_2": "SUITE 310",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054857",
            "telephone_number": "208-454-2035",
            "fax_number": "208-454-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "BRENDA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2009-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "G05134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "15024",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207527",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010001161",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003658200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.