NPI age
20 years
Enumerated 2005-11-02
● Active
Type 1 · Individual
Brian David Miller, PA-C BS
Miller is 1 of 44 physician assistant providers in Idaho Falls and 1 of 387 in Idaho.
Primary specialty
Physician Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2023-03-07
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 387 active physician assistant providers in Idaho.
NPI age
20 years
↑ 5 yr above median (15 yr)
State licenses
1 state
16% of peers hold multiple states
Subspecialties
0
30% of peers hold subspecialties
NPI lifetime · 2005 → 2026
2005-11Enumerated in NPPES
2005
2026
Where they practice
Practice location
2680 Channing Way
Idaho Falls, ID 834047517
Mailing address
2680 Channing Way
Idaho Falls, ID 834047517
Specialties
-
Physician Assistant PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 1041907 | PACIFIC SOURCE |
| 05 (ID) | 8059104-00 | |
| 01 (ID) | PA-309 | ID STATE LISC |
Practice context
Part of a multi-provider practice. 9 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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