William Brad Speakman, D.O.
Individual provider Active NPI Family Medicine Physician · Malad City, ID
NPI 1821034562 · NPPES record last updated Jun 9, 2022
Key facts
- NPI
- 1821034562
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- O-240 (ID)
- Practice address
- 220 Bannock St
Malad City, ID 83252-5068 - Phone
- (208) 766-2600
- Fax
- (208) 766-4258
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 16
Hospital & facility affiliations 3
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- BMH Inc
Practice addresses (Care Compare)
315 W Idaho St
Blackfoot, ID 83221-1711
Phone (208) 782-3990
98 Poplar St
Blackfoot, ID 83221-1758
Phone (208) 785-4100
Hospital & facility affiliations
- Bingham Memorial Hospital
- North Platte Valley Medical Center
- Bingham Memorial Skilled Nursing & Rehabilitation
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ID, WY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Bingham Memorial Hospital |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
May 23, 2023 Jan 30, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040720000727 | ID | Practitioner - Family Practice |
3577542752 | Reassigns benefits to 3 organizations |
| I20260530000599 | WY | Practitioner - Family Practice | 3577542752 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BMH, Inc. | Current |
Accepting new patients | |
| BMH, Inc. | Family Medicine | Current |
Accepting new patients |
| Oneida County Hospital | Current | Accepting new patients | |
| Oneida County Hospital | Current |
Accepting new patients | |
| BMH, Inc. | Current | Accepting new patients | |
| BMH Inc | Current |
Accepting new patients | |
| Oneida County Hospital | Current | Accepting new patients | |
| Oneida County Hospital | Current |
Accepting new patients | |
| Community Care, PLLC | Family Medicine | Past | Accepting new patients |
Locations
3456 E 17th St
Ste 125
Ammon, ID 83406
Phone (208) 529-2828
98 Poplar St
Fl 1
Blackfoot, ID 83221
98 Poplar St
Blackfoot, ID 83221
Phone (208) 782-3763
1350 Parkway Dr
Ste B
Blackfoot, ID 83221
1350 Parkway Dr
Ste A
Blackfoot, ID 83221
315 W Idaho St
Blackfoot, ID 83221
Phone (208) 782-3990
2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686
3302 Valencia Dr
Ste 120
Idaho Falls, ID 83404
Phone (208) 535-3635
3302 Valencia Dr
Ste 201
Idaho Falls, ID 83404
Phone (208) 524-9400
220 Bannock St
Malad City, ID 83252
Phone (208) 766-2231
4750 Yellowstone Ave
Ste B
Pocatello, ID 83202
Phone (208) 232-8792
4750 Yellowstone Ave
Pocatello, ID 83202
Phone (208) 233-1720
850 Yellowstone Ave
Ste A
Pocatello, ID 83201
Phone (208) 239-8065
4750 Yellowstone Ave
Ste A
Pocatello, ID 83202
Phone (208) 233-1720
850 Yellowstone Ave
Ste B
Pocatello, ID 83201
Phone (208) 239-8066
275 W Locust St
Ste A
Shelley, ID 83274
Interoperability endpoints
- wspeakman@bmh.medalliesdirect.net
- williamspeakman@bmh.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | O-240 | ID | Yes |
Addresses
Primary practice location
220 Bannock St
Malad City, ID 83252-5068
Mailing address
220 Bannock St
Malad City, ID 83252-5068
Phone (208) 766-2600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 805780000 | Medicaid | ID |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ehr-direct@oneidacountyclinic.hin.us | Health Information Exchange (HIE) |
Other providers in Malad City, ID
- Camille Schow
- Scott Service
- Macall Annila Smith
- Nacona N Smith
- Southeastern Idaho Medical Clinics
- Dallas R Spencer
- Summit Creek Counseling LLC
- Ariel Shantay Avis Taysom
- Edgar Blair Thorpe
- Valley View Counseling LLC
All providers in Malad City, ID · Family Medicine Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.