DR. BRENT H. GREENWALD


Address: 3155 Channing Way, Suite B, Idaho Falls, ID 83404-7546
Phone: 2085354800

DR. BRENT H. GREENWALD (NPI# 1134155666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134155666
Entity Type Individual
Full Name DR. BRENT H. GREENWALD
Credential M.D.
Practice Address 3155 Channing Way
Suite B
Idaho Falls
ID 83404-7546
Practice Telephone 2085354800
Practice Fax Number 2085354807
Mailing Telephone 2085354800
Mailing Fax Number 2085354807
Enumeration Date 2006-06-25
Last Update Date 2009-07-13
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207T00000X Neurological Surgery M-6947 ID Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
ID BLUE CROSS PRACTICE 8M987 01
ID BLUE SHIELD 000010001551 01
ID BLUE CROSS 76836 01
ID 002786100 05
ID TAX ID NO 82-0529781 01

Office Location

Street Address 3155 CHANNING WAY
SUITE B
City IDAHO FALLS
State ID
Zip Code 83404-7546

Providers in the same location

NPI Name Taxonomy Address Enumeration
1740693050 Mark Thompson Physical Therapist 3155 Channing Way, Suite D, Idaho Falls, ID 83404-7534 2014-06-04
1417383654 Jed G Loertscher Physical Therapist 3155 Channing Way, Suite D, Idaho Falls, ID 83404-7534 2013-09-19
1700174489 Christopher A Rigby Physical Therapist 3155 Channing Way, Suite D, Idaho Falls, ID 83404-7534 2011-07-15
1215220587 Greg J Bailey Physical Therapist 3155 Channing Way, Suite D, Idaho Falls, ID 83404-7534 2011-05-19
1760621080 Kari Anne Lasco-sanders Physical Therapist 3155 Channing Way, Suite D, Idaho Falls, ID 83404-7534 2009-02-10
1215089768 Shannon Kay West Specialist/Technologist, Other 3155 Channing Way, Suite B, Idaho Falls, ID 83404-7561 2007-01-17
1528127057 Greenwald Neurosurgical PC Surgery 3155 Channing Way, Suite B, Idaho Falls, ID 83404-7561 2006-12-08
1124198403 Greenwald Neurosurgical Specialist 3155 Channing Way, Suite B, Idaho Falls, ID 83404-7546 2006-11-08
1871687970 Nathan Allen Hunsaker Specialist 3155 Channing Way, Suite D, Idaho Falls, ID 83404-7534 2006-10-03

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437750809 Joshua M Murphy Dentist 1580 Elk Creek Dr., Idaho Falls, ID 83404 2020-11-03
1427618958 Eastern Idaho Endodontics Dentist 3335 S. Holmes Ave, Idaho Falls, ID 83404 2019-06-17
1942863600 Muhammad Arslan Khan Student in an Organized Health Care Education/Training Program 2860 Channing Way Suite 214, Idaho Falls, ID 83404 2019-04-18
1942771043 Physician's Choice Cardiology, Pllc Internal Medicine 3302 Valencia, Suite 201, Idaho Falls, ID 83404 2018-12-16
1609358761 Cardiac Cath Lab of Idaho Falls Internal Medicine 3311 Valencia Drive, Idaho Falls, ID 83404 2018-09-05
1083196380 Hannah Golden Occupational Therapist 1460 Elk Creek, Idaho Falls, ID 83404 2018-09-04
1316423049 Lindsay Sessions Speech-Language Pathologist 2210 Niagara St, Idaho Falls, ID 83404 2018-07-16
1720574023 Bmh, Inc. Anesthesiology 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 2018-07-10
1093237935 Jason Earl Bailey Contractor 3100 S Woodruff Ave., Idaho Falls, ID 83404 2017-07-12
1235682121 Mountain Falls Quick Care Clinic/Center 1995 E 17th St #1, Idaho Falls, ID 83404 2016-07-27
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Taxonomy Information

Taxonomy Code 207T00000X
Grouping Allopathic & Osteopathic Physicians
Classification Neurological Surgery

Taxonomy Definition

A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1962592022 Robert Lee Cach Neurological Surgery 2375 E Sunnyside Rd Ste G, Idaho Falls, ID 83404-8281 2006-10-12
1558457572 Stephen R Marano Neurological Surgery 1975 Martha Ave, Ste A, Idaho Falls, ID 83404-7580 2006-10-05
1780679126 Clark Hunter Allen Neurological Surgery 3345 Potomac Way, Idaho Falls, ID 83404 2005-09-13
1750787297 Idaho Neurosurgery & Spine Pllc Neurological Surgery 3345 Potomac Way, Idaho Falls, ID 83404 2014-11-11
1457606279 John D Dickinson Neurological Surgery 3345 Potomac Way, Idaho Falls, ID 83404 2012-07-18
1477798148 Idaho Neurosurgical Center, Pa Neurological Surgery 2375 E Sunnyside Rd, Suite G, Idaho Falls, ID 83404-8280 2008-12-10
1295942142 Brandon Reyes Kelly Neurological Surgery 3345 Potomac Way, Idaho Falls, ID 83404 2007-05-17
1992834089 Stephen R Marano Md PC Neurological Surgery 2375 E Sunnyside Rd, Ste F, Idaho Falls, ID 83404-7579 2007-03-05
1497838478 James Lee Cook Neurological Surgery 1975 Martha Ave, Ste A, Idaho Falls, ID 83404-7580 2006-10-23

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1245603505 Scott Huneycutt Md Pllc Neurological Surgery 2240 E Center St Ste A, Pocatello, ID 83201-2600 2015-11-09
1992049696 William Bradford Delong Neurological Surgery 222 Blue Ridge Ct, Orofino, ID 83544-9019 2012-11-19
1932373453 Michael Raber Neurological Surgery 2236 N Merritt Creek Loop Ste A, Coeur D Alene, ID 83814-4960 2008-04-15
1578743522 Richard Lochhead Neurological Surgery 6140 W. Curtisian Ave, Ste 400, Boise, ID 83604-8907 2007-11-07
1649353947 Jeffrey J Larson Neurological Surgery 3320 N Grand Mill Ln, Coeur D Alene, ID 83814-5689 2006-10-23
1962508366 Bret A Dirks Neurological Surgery 850 W Ironwood Dr Suite 300, Coeur Dalene, ID 83814 2006-09-15
1558472910 Jeffrey Dean Mcdonald Neurological Surgery 980 W Ironwood Drive, #206, Coeur D Alene, ID 83814 2006-08-31
1497788160 William Francis Ganz Neurological Surgery 2236 N Merrit Creek Loop, Suite A, Coeur D Alene, ID 83814-4960 2006-07-08
1780620765 Donald S Soloniuk Neurological Surgery 324 5th St, Suite 101, Lewiston, ID 83501-2408 2006-06-20
1588665434 D Peter Reedy Neurological Surgery 999 N Curtis, #307, Boise, ID 83706-1333 2005-08-02
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Competitor

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City IDAHO FALLS
Zip Code 83404

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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