Individual provider Active NPI

Barton Adrian, M.D.

  • Pediatric Adolescent Medicine Physician
  • Hailey, ID
National Provider Identifier
1548201932
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
M4329 Issued in ID
Practice address
1450 Aviation Dr
Suite 100
Hailey, ID 83333-8785
Phone
(208) 788-3434
Fax
(208) 788-2025
NPI assigned
Jun 9, 2006
Last updated
Sep 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X M4329 ID Primary

Addresses

Primary practice location

1450 Aviation Dr
Suite 100
Hailey, ID 83333-8785

Mailing address

PO Box 587
Twin Falls, ID 83303-0587
Phone (208) 814-7400

Other identifiers 1

IdentifierTypeStateIssuer
003572400MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M4329IDMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Magic Valley Regional Medical Center LTD Past Accepting new patients
St Luke's Clinic LLC PastSince Apr 28, 2015 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1548201932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 587",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833030587",
            "telephone_number": "208-814-7400",
            "fax_number": "208-814-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 AVIATION DR",
            "address_2": "SUITE 100",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338785",
            "telephone_number": "208-788-3434",
            "fax_number": "208-788-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADRIAN",
        "first_name": "BARTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "ID",
            "license": "M4329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003572400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hailey, ID

Sources for this page

Verify at the official NPI Registry.