P Praxis·MD
● Active Type 2 · Organization

Burn And Reconstructive Centers Of Idaho, Pllc

Specialist·Idaho Falls, ID· NPI 1902360639 · Enumerated 2019 · 7 years on NPI
Burn And Reconstructive Centers Of Idaho, Pllc is 1 of 305 specialist organizations in Idaho.
NPI age
7 years
Enumerated 2019-01-28
Primary specialty
Specialist
Practice locations
5
4 secondary on file
Status
Active
No deactivations on record
Authorized official
Fagan
Owner/md
Last NPPES update
2022-10-11
Source: monthly bulk 2026-05

How this organization compares

Across 305 active specialist providers in Idaho.

NPI age
7 years
↓ 11 yr below median
Practice locations
5
4 secondary on file
Subspecialties
0

NPI lifetime · 2019 → 2026

2019-01Enumerated in NPPES
2019 2026

Where they practice

Primary practice location
3100 Channing Way
Idaho Falls, ID 834047533
📞 7068639595fax 7068688375
Mailing address
Po Box 12358
Augusta, GA 309142358
📞 7068639595fax 7068688375

Additional practice locations

4 secondary locations on file with NPPES.

Location 2
7700 Floyd Curl Dr
San Antonio, TX 782293902
📞 7068639595fax 7068688375
Location 3
2325 Coronado St
Idaho Falls, ID 834047407
📞 7068639595fax 7068688375
Location 4
3200 Channing Way Ste 206a&b
Idaho Falls, ID 834047546
📞 7068639595fax 7068688375
Location 5
3901 W 15th St
Plano, TX 750757738
📞 7068639595fax 7068688375

Authorized official

Shawn Fagan
Owner/md
📞 7068639595

Individual providers at this organization

20 individual providers on file at this primary practice address.

Specialties

  • Specialist Primary
    An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
    taxonomy 174400000X

Practice context

Multi-provider organization. 20 individual providers on file at this primary address. Plus 4 secondary practice locations.

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How to verify this organization

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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