NPIMap

Organization Active NPI

Surgical Specialties Clinic

  • Surgery Physician
  • Emmett, ID
National Provider Identifier
1821334657
Registry record updated Nov 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
O-0674 Issued in ID
Legal business name
SURGICAL SPECIALTIES CLINIC
Practice address
1024 E Locust St
Emmett, ID 83617-2776
Phone
(208) 365-2338
NPI assigned
Dec 26, 2012
Organization subpart
Yes
Parent organization
WALTER KNOX MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 30, 2019

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

Authorized official

Name
Brad Turpen
Title
Ceo
Phone
(208) 999-3870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X O-0674 ID Primary

Addresses

Primary practice location

1024 E Locust St
Emmett, ID 83617-2776

Mailing address

1202 E Locust St
Emmett, ID 83617-2715
Phone (208) 365-2338

National Provider Directory

National Provider Directory
Tax ID family
Walter Knox Memorial Ho5 organizations share this tax ID, including this one
Part of
Walter Knox Memorial Ho

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1356480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575072000000",
    "number": "1821334657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 E LOCUST ST",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836172715",
            "telephone_number": "208-365-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 E LOCUST ST",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836172776",
            "telephone_number": "208-365-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SPECIALTIES CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALTER KNOX MEMORIAL HOSPITAL",
        "enumeration_date": "2012-12-26",
        "last_updated": "2019-11-30",
        "status": "A",
        "authorized_official_last_name": "TURPEN",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-999-3870"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "ID",
            "license": "O-0674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emmett, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2019; 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.