NPIMap

Organization Active NPI

Cep America, LLC

  • Emergency Medicine Physician
  • Nampa, ID
National Provider Identifier
1629438833
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CEP AMERICA, LLC
Practice address
1510 12TH Ave Rd Ste 100
Nampa, ID 83686-6008
Phone
(208) 498-1333
NPI assigned
Mar 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Authorized official

Name
David Birdsall, M.D
Title
C.O.O.
Phone
(510) 350-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

1510 12TH Ave Rd Ste 100
Nampa, ID 83686-6008

Mailing address

1601 Cummins Dr Ste D
Modesto, CA 95358-6411
Phone (510) 350-2600

Other names 1

  • Vituity Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160803003292 ID Part B Supplier - Clinic/Group Practice 6608056171 Receives reassigned benefits from 110 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boise, ID; Eagle, ID; Nampa, ID; Pocatello, ID

National Provider Directory

National Provider Directory

Locations

323 E Riverside Dr
Eagle, ID 83616
Phone (208) 302-6000

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585699200000",
    "number": "1629438833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CUMMINS DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586411",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 12TH AVE RD STE 100",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866008",
            "telephone_number": "208-498-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEP AMERICA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-01",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A",
        "authorized_official_last_name": "BIRDSALL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "510-350-2600",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vituity",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.