BRYCE WADE ANDERSEN (NPI# 1174955306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174955306 |
| Entity Type | Individual |
| Full Name | BRYCE WADE ANDERSEN |
| Credential | NP-C |
| Practice Address |
2730 Channing Way Idaho Falls ID 83404-5049 |
| Mailing Address |
3380 E 155 N Rigby ID 83442-5272 |
| Practice Telephone | 2085427100 |
| Mailing Telephone | 2085213870 |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2013-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
NP1303A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205994134 | Bryce Charles Andersen | Registered Nurse | 15400 E 14th Pl, Aurora, CO 80011-5818 | 2006-12-04 |
| 1083237580 | Bryce Andersen | Community Health Worker | 1300 N 17th Ave, Greeley, CO 80631-9584 | 2020-05-19 |
| Street Address |
2730 CHANNING WAY |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-5049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598837031 | Anne L Broadway | Family Medicine | 2730 Channing Way, Idaho Falls, ID 83404-5049 | 2006-11-13 |
| 1740816511 | Hilary Zitlau | Physician Assistant | 2730 Channing Way, Idaho Falls, ID 83404-5049 | 2020-03-12 |
| 1114493665 | Karla Dawn Patterson | Nurse Practitioner | 2730 Channing Way, Idaho Falls, ID 83404-5049 | 2018-10-22 |
| 1730655283 | David Winchester | Nurse Practitioner | 2730 Channing Way, Idaho Falls, ID 83404-5049 | 2018-10-22 |
| 1841747540 | Anthony R Berrett | Physician Assistant | 2730 Channing Way, Idaho Falls, ID 83404-5049 | 2016-09-09 |
| 1093186280 | Karma Youngstrom | Physician Assistant | 2730 Channing Way, Idaho Falls, ID 83404-5049 | 2015-10-13 |
| 1093103699 | Tara Powell | Physician Assistant | 2730 Channing Way, Idaho Falls, ID 83404-5049 | 2015-01-05 |
| 1831518992 | Demetrios Plomaritis | Physician Assistant | 2730 Channing Way, Idaho Falls, ID 83404-5049 | 2014-04-15 |
| 1730423492 | Mountain View Hospital LLC | Durable Medical Equipment & Medical Supplies | 2730 Channing Way, Idaho Falls, ID 83404-5049 | 2012-11-19 |
| 1639442973 | Trevor R Bartlett | Nurse Practitioner | 2730 Channing Way, Idaho Falls, ID 83404-5049 | 2012-02-16 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 83404 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871191254 | Bradley Radford | Nurse Practitioner | 2001 S Woodruff Ave Ste 15b, Idaho Falls, ID 83404-6372 | 2020-10-16 |
| 1619416674 | Kathryn Nielsen | Nurse Practitioner | 3910 Washington Pkwy, Idaho Falls, ID 83404-7596 | 2017-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891308094 | Brandon Paul Kruse | Nurse Practitioner | 3345 S Fork Ave, Nampa, ID 83686-4855 | 2020-08-26 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1558986521 | Lisa Kay Stimpson | Nurse Practitioner | 1605 Poen Rd, Kuna, ID 83634-1743 | 2020-06-15 |
| 1730714049 | Care Medical Housecalls PC | Nurse Practitioner | 2040 E Holgate Ct, Eagle, ID 83616 | 2020-03-06 |
| 1295372308 | Elizabeth Balleweg | Nurse Practitioner | 2306 N 31st St, Boise, ID 83703-5628 | 2019-12-09 |
| 1891264545 | Tina Monique Bossolono-williams | Nurse Practitioner | 1385 Parkview Dr Ste 101, Twin Falls, ID 83301-4084 | 2018-11-23 |
| 1821525452 | Kristin Meshelle Hofmann | Nurse Practitioner | 420 W Main St Ste 206, Boise, ID 83702-7363 | 2017-05-14 |
| 1992237648 | Candice Elaine Adams | Nurse Practitioner | 5108 N Maidstone Way, Boise, ID 83713-1367 | 2017-03-31 |
| 1851832695 | Penny Rea | Nurse Practitioner | 5307 Green Valley Pl, Nampa, ID 83686-5790 | 2017-03-13 |
| 1891176798 | Christine Cooper | Nurse Practitioner | 35 W Idaho St, Weiser, ID 83672 | 2015-06-16 |
| Find all providers with the same taxonomy | ||||
| City | IDAHO FALLS |
| Zip Code | 83404 |
Please comment or provide details below to improve the information on BRYCE WADE ANDERSEN.
| 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.