MR. BRADLY KENNETH LEROY BROWN PA-C NPI 1043598477

NPI Information

  • NPI: 1043598477
  • Provider Name: MR. BRADLY KENNETH LEROY BROWN, PA-C
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2730 CHANNING WAY
    IDAHO FALLS, ID
    ZIP 83404
  • Phone: (208) 542-7100

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NPI Details

MR. Bradly Kenneth Leroy Brown, PA-C is a family medicine in Idaho Falls, ID with 14 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MR. Bradly Kenneth Leroy Brown, PA-C NPI is 1043598477. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduation Year:2011

The provider's business location address is:

2730 CHANNING WAY
IDAHO FALLS, ID
ZIP 83404-049
Phone: (208) 542-7100
Fax: (208) 542-7150

The NPI 1043598477 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Removal of impacted ear wax (HCPCS:69210)

The enumeration date for this NPI number is 8/3/2011 and was last updated on 9/13/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicinePA965IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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