Brian W Christensen M.D. PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

M7414 Issued in ID

Legal business name

BRIAN W CHRISTENSEN M.D. PA

Practice address

20 Madison Professional Park
Rexburg, ID 83440-2058

Phone

(208) 656-9008

Fax

(208) 656-0999

NPI assigned

Sep 24, 2008

Organization subpart

No

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

Authorized official

Name

Brian W Christensen, M.D., PANPI 1811022056

Title

Surgeon

Phone

(208) 656-9008

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

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

• Brian Wade Christensen, M.D.

  • Surgery Physician
  • Rexburg, ID
  • NPI 1811022056

  ID, Surgery

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225065600000",
    "number": "1740430834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MADISON PROFESSIONAL PARK",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402058",
            "telephone_number": "208-656-9008",
            "fax_number": "208-656-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MADISON PROFESSIONAL PARK",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402058",
            "telephone_number": "208-656-9008",
            "fax_number": "208-656-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN W CHRISTENSEN M.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2008-10-27",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "208-656-9008",
        "authorized_official_credential": "M.D., PA"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "ID",
            "license": "M7414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010004529",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805130600",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "DT307",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• James M Brannon, ED.D.
• Marilyn E Brannon, PH.D.
• Briarwood Safe House LLC
• Alexander Ray Brinkley, PTA
• Broulim Supermarkets, LLC
• Colby Ray Brower, MD
• Eric Lee Brown, NP-C

• All providers in Rexburg, ID
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2008; 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.