Bryan C Pogue MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M5125 Issued in ID

Legal business name

BRYAN C POGUE MD

Doing business as

Selah Medical Center, PA

Practice address

6565 W Emerald St
Boise, ID 83704-8737

Phone

(208) 377-5055

Fax

(208) 377-5335

NPI assigned

Jun 16, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Kelli M Sizemore, CMPE

Title

Administrator

Phone

(208) 377-5055

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Selah Medical Center, PA Doing business as

Locations

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1477558328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048737",
            "telephone_number": "208-377-5055",
            "fax_number": "208-377-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048737",
            "telephone_number": "208-377-5055",
            "fax_number": "208-377-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN C POGUE MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "SIZEMORE",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-377-5055",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CMPE"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M5125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002789800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Selah Medical Center, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alana Jo Brunner, LCPC, NCC
• Rachel Brunner, PT, DPT
• Kattie Lynn Bruno, LMSW
• Scott Brunson, MD
• Nancy A Brus, M.D.
• Bryan J Anderson MD PC
• Bryan James Anderson MD PC
• Crystalyn Lou Bryan, NP-C
• Thornton E Bryan III, MD
• Brian Eric Bryant, RN

• Family Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.