Julian Debruynkops MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M3222 Issued in ID

Legal business name

JULIAN DEBRUYNKOPS MD PA

Practice address

2065 E 17TH St
Suite C
Idaho Falls, ID 83404-8042

Phone

(208) 522-6106

NPI assigned

Sep 16, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Julian De Bruyn Kops, MDNPI 1922086552

Title

Director

Phone

(208) 522-6106

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 2

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

• Julian De Bruyn Kops III, MD

  • Family Medicine Physician
  • Idaho Falls, ID
  • NPI 1922086552
  Medicare reassignment Care Compare group NPD Authorized official
• Samantha De Bruyn Kops, APRN, FNP-C

  • Family Nurse Practitioner
  • Idaho Falls, ID
  • NPI 1730744947
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290124800000",
    "number": "1932417607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2065 E 17TH ST",
            "address_2": "SUITE C",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048042",
            "telephone_number": "208-522-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2065 E 17TH ST",
            "address_2": "SUITE C",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048042",
            "telephone_number": "208-522-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIAN DEBRUYNKOPS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-11-19",
        "status": "A",
        "authorized_official_last_name": "DE BRUYN KOPS",
        "authorized_official_first_name": "JULIAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "208-522-6106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M3222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karie E Josten, PA-C
• Jason Christopher Joyner, PA-C
• JSC Anesthesia PC
• Jubilation House, LLC
• Madison Judy
• Ryan Julian, DO
• Julius Behavioral Corporation
• Juniper Counseling PLLC
• Just 4 Kids Health LLC (Just 4 Kids Urgent Care)
• Just 4 Kids Health LLC (Just 4 Kids Mental Health)

• Family Medicine Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; 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.