BRANDON S TRACY (NPI# 1710403746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710403746 |
| Entity Type | Individual |
| Full Name | BRANDON S TRACY |
| Credential | FNP-C |
| Practice Address |
1049 Summers Dr Rexburg ID 83440-5335 |
| Practice Telephone | 2083594841 |
| Practice Fax Number | 2083594842 |
| Mailing Telephone | 2083594841 |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2019-10-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 60637 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP60637 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 150 S Main St Ste 1, Driggs, ID 834225022 | 2083594841 | 2083594842 |
| 1619 Nw Hawthorne Ave Ste 201, Grants Pass, OR 975266009 | 5415071881 | |
| 385 Ranch Rd, Reedsport, OR 974671707 | 8442094499 | |
| 790 E 5th St, Coquille, OR 974231755 | 8442094499 |
| Street Address |
1049 SUMMERS DR |
| City | REXBURG |
| State | ID |
| Zip Code | 83440-5335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588802391 | Alpine Dermatology Clinic P.C. | Clinic/Center | 1049 Summers Dr, Rexburg, ID 83440-5335 | 2009-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235768490 | Henry's Fork Surgery Center Pllc | Clinic/Center | 23 Sawtelle Ave, Rexburg, ID 83440 | 2020-04-08 |
| 1952956906 | Shane Ellis Withers | Pharmacist | 164 E. Main, Rexburg, ID 83440 | 2019-08-06 |
| 1316392285 | Emma Anderson | Speech-Language Pathologist | 36 Professional Plaza Suite 110, Rexburg, ID 83440 | 2016-04-28 |
| 1851755524 | Sandra Frickey | Speech-Language Pathologist | 1087 Summers Drive, Premier Therapy Associates, Rexburg, ID 83440 | 2016-04-08 |
| 1275997215 | Kerry Denney | Counselor | 333 Walker Drive, Rexburg, ID 83440 | 2016-04-06 |
| 1467837583 | Wal-mart Stores, Inc. | Technician/Technologist | 303 E Moody Rd, Rexburg, ID 83440 | 2015-07-30 |
| 1649692609 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 410 W 1st N, Rexburg, ID 83440 | 2014-01-10 |
| 1043652571 | Creed Simon Webster | Counselor | 30 S 2nd W, Rexburg, ID 83440 | 2013-07-25 |
| 1033461660 | James Cannon Allen Dds PC | Dentist | 106 E 1st North, Rexburg, ID 83440 | 2012-10-05 |
| 1417217316 | Shelby Dee Woolstenhulme | Speech-Language Pathologist | 450 E. Main Street, Rexburg, ID 83440 | 2012-05-24 |
| Find all providers in zip 83440 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528044955 | David G Holland | Nurse Practitioner | Sch 100, Rexburg, ID 83460-2010 | 2005-12-19 |
| 1760467625 | Lori Ann Parker | Nurse Practitioner | Shc 100, Byu Idaho, Rexburg, ID 83460-2010 | 2005-12-13 |
| 1720502370 | Vista Healthcare PC | Nurse Practitioner | 556 Trejo St Ste B, Rexburg, ID 83440-2626 | 2017-07-26 |
| 1649699216 | Mvh Bmc LLC | Nurse Practitioner | 37 S 2nd E, Rexburg, ID 83440-1906 | 2014-04-10 |
| 1558662064 | Linda R Webster | Nurse Practitioner | 36 Professional Plz, Rexburg, ID 83440-2049 | 2010-11-15 |
| 1275794851 | Nichole Ann Jeppesen | Nurse Practitioner | 393 E 2nd N, Rexburg, ID 83440-1605 | 2008-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039988 | Seth Thomas Six | Nurse Practitioner | 803 Mill Rd, Lewiston, ID 83501-0745 | 2020-09-25 |
| 1255947255 | Brandon Smith | Nurse Practitioner | 5067 Camden St, Chubbuck, ID 83202-3501 | 2020-09-16 |
| 1407469166 | Mmg LLC | Nurse Practitioner | 80 Cottonwood Ct Ste 150, Eagle, ID 83616-6577 | 2020-08-24 |
| 1588288336 | Katina Ross | Nurse Practitioner | 11695 W Baserri Dr, Boise, ID 83709-1307 | 2020-06-07 |
| 1164043162 | Slavik Osipchuk | Nurse Practitioner | 2329 W Root Creek St, Meridian, ID 83646-4678 | 2020-04-30 |
| 1538708862 | Kay Dawn Martens | Nurse Practitioner | 334 E 200 S, Burley, ID 83318-5433 | 2020-01-03 |
| 1760025639 | Kimberly Watson | Nurse Practitioner | 3536 W Moon Lake St, Meridian, ID 83646-8304 | 2019-10-23 |
| 1932741212 | Kylie B Di Lulo | Nurse Practitioner | 1309 E Fall Ct, Boise, ID 83706-5076 | 2019-10-08 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1649824277 | Bryana Michel Hinck | Nurse Practitioner | 150 W Broderick Dr, Meridian, ID 83646-0009 | 2019-07-31 |
| Find all providers with the same taxonomy | ||||
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| 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.