BRAD REID EDWARDS DO NPI 1093829657

NPI Information

NPI: 1093829657
Provider Name: BRAD REID EDWARDS, DO
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
3430 WASHINGTON PKWY
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 523-3060
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Brad Reid Edwards, DO is a pediatrics in Idaho Falls, ID. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Brad Reid Edwards, DO NPI is 1093829657. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3430 WASHINGTON PKWY
IDAHO FALLS, ID
ZIP 83404-579
Phone: (208) 523-3060
Fax: (208) 523-0028

The enumeration date for this NPI number is 8/19/2006 and was last updated on 9/30/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		O316	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	H62360	MEDICARE UPIN
2	000010143893	OTHER	IDAHO	BLUE SHIELD
3	123957100	MEDICAID	WYOMING
4	1285786046	MEDICAID	WYOMING
5	54380	OTHER	IDAHO	BLUE CROSS
6	806644500	MEDICAID	IDAHO
7	0117436	MEDICAID	MONTANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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