Organization Active NPI

Idaho Bariatric and Metabolic Institute L.L.C.

  • Surgery Physician
  • Meridian, ID
National Provider Identifier
1477014207
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
IDAHO BARIATRIC AND METABOLIC INSTITUTE L.L.C.
Practice address
2960 E. St. Luke'S St.
Suite 200
Meridian, ID 83642-9005
Phone
(208) 378-4264
Fax
(208) 957-6891
NPI assigned
Mar 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Authorized official

Name
David J Brown, MDNPI 1184652364
Title
Physician
Phone
(208) 378-4264

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Obstetrics & Gynecology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VB0002X
Obesity Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083B0002X
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

2960 E. St. Luke'S St.
Suite 200
Meridian, ID 83642-9005

Mailing address

2960 E. St. Luke'S St.
Suite 200
Meridian, ID 83642-9005
Phone (208) 378-4264

Other identifiers 1

IdentifierTypeStateIssuer
1184652364MedicaidID

National Provider Directory

National Provider Directory

Locations

2960 E St Lukes St Ste 200
Ste 200
Meridian, ID 83642
Phone (208) 378-4264

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1477014207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 E. ST. LUKE'S ST.",
            "address_2": "SUITE 200",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429005",
            "telephone_number": "208-378-4264",
            "fax_number": "208-957-6891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 E. ST. LUKE'S ST.",
            "address_2": "SUITE 200",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429005",
            "telephone_number": "208-378-4264",
            "fax_number": "208-957-6891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO BARIATRIC AND METABOLIC INSTITUTE L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-26",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "208-378-4264",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184652364",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.