Walter Kurt Birkenhagen, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

M3705 Issued in ID

Practice address

500 S 11TH Ave
Pocatello, ID 83201-4835

Phone

(208) 232-7434

Fax

(208) 233-6446

NPI assigned

Aug 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Judy PC

  • Surgery Physician
  • Pocatello, ID
  • NPI 1528152758
  NPD (past)
• Optimum Health, PLLC

  • Emergency Medicine Physician
  • Pocatello, ID
  • NPI 1306401575
  NPD (past)

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1407849060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014835",
            "telephone_number": "208-232-7434",
            "fax_number": "208-233-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014835",
            "telephone_number": "208-232-7434",
            "fax_number": "208-233-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRKENHAGEN",
        "first_name": "WALTER",
        "middle_name": "KURT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "M3705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002370100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Bills, M.A.ED., LCPC
• Nicole Grace Binggeli
• Baylee Biorn
• Chloe Burton Birchfield, DMD
• Megan Olsen Bird, PH.D.
• Jackie Birrer-Atkinson
• Randy Lyman Bishop, M.S.
• Christine E Black, MD
• Robert Grant Black, PT
• Melanie Blackburn

• Surgery Physician in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.