NPIMap

Organization Active NPI

Idaho Emergency Physicians, P.a.

  • Emergency Medicine Physician
  • Meridian, ID
National Provider Identifier
1730133208
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
IDAHO EMERGENCY PHYSICIANS, P.A.
Practice address
2963 E Copper Point Dr
Suite 150
Meridian, ID 83642-9055
Phone
(208) 322-1730
Fax
(208) 322-1731
NPI assigned
May 20, 2006
Last updated
Sep 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Authorized official

Name
Brandon Wiliding, M.D.
Title
Chairman and President
Phone
(208) 322-1730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

2963 E Copper Point Dr
Suite 150
Meridian, ID 83642-9055

Mailing address

PO Box 5666
Denver, CO 80217-5666
Phone (208) 322-1730

Other identifiers 1

IdentifierTypeStateIssuer
002426500MedicaidID

National Provider Directory

National Provider Directory

Locations

2312 N Cole Rd
Ste B
Boise, ID 83704
Phone (208) 322-1730

2963 E Copper Point Dr
Meridian, ID 83642
Phone (208) 322-1730

2963 E Copper Point Dr
Ste 150
Meridian, ID 83642
Phone (208) 322-1730

Practitioners & affiliated clinicians

Practitioners 57

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1730133208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5666",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175666",
            "telephone_number": "208-322-1730",
            "fax_number": "208-322-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2963 E COPPER POINT DR",
            "address_2": "SUITE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429055",
            "telephone_number": "208-322-1730",
            "fax_number": "208-322-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO EMERGENCY PHYSICIANS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "WILIDING",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "CHAIRMAN AND PRESIDENT",
        "authorized_official_telephone_number": "208-322-1730",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002426500",
            "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 Sep 25, 2015; 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.