Active NPI
Brennan N Carmody, NP
- Nurse Practitioner
- Meridian, ID
National Provider Identifier
1629400734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NP1318A
- Practice address
- 176 E Calderwood Dr Ste 150D
Meridian, ID 83642-9095 - Phone
- (208) 402-8946
- Fax
- (208) 248-6939
- NPI assigned
- Jul 31, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | NPPEND | ID | |
| Nurse Practitioner | 363L00000X | NP1318A | ID | Primary |
Addresses
Primary practice location
176 E Calderwood Dr Ste 150D
Meridian, ID 83642-9095
Mailing address
2169 W Oakhampton Dr
Eagle, ID 83616-7632
Phone (208) 631-2121
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G8937328 | Other | WA | MEDICARE |
| 0338594 | Other | WA | L&I |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP1318A | ID | MD | Nurse Practitioner |
| NPPEND | ID | MD | Obstetrics & Gynecology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Family Medicine PLLC | Current | Accepting new patients | |
| Kuna Healthcare Clinic, PLLC | Nurse Practitioner | Current | Accepting new patients |
| Sacred Roots Fertility Consulting, PLLC | Current | Accepting new patients |
Locations
943 N Linder Rd
Ste 103
Kuna, ID 83634
Phone (208) 565-0978
520 S Eagle Rd
Ste 3209
Meridian, ID 83642
Phone (208) 345-5250
Organizations & group practices 3
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.
-
- Women's Health Nurse Practitioner
- Meridian, ID
- NPI 1992655526
-
- Family Medicine Physician
- Kuna, ID
- NPI 1598822231
-
- Nurse Practitioner
- Kuna, ID
- NPI 1114489788
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769990400000",
"number": "1629400734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2169 W OAKHAMPTON DR",
"city": "EAGLE",
"state": "ID",
"postal_code": "836167632",
"telephone_number": "208-631-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "176 E CALDERWOOD DR STE 150D",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836429095",
"telephone_number": "208-402-8946",
"fax_number": "208-248-6939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARMODY",
"first_name": "BRENNAN",
"middle_name": "N",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-31",
"last_updated": "2026-02-02",
"certification_date": "2026-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "ID",
"license": "NPPEND",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "ID",
"license": "NP1318A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "G8937328",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "0338594",
"state": "WA"
}
],
"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 Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.