Active NPI
Bradly Kenneth Leroy Brown, PA-C
- Family Medicine Physician
- Twin Falls, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- PA-965
- Practice address
- 725 Pole Line Rd W
Twin Falls, ID 83301-5800 - Phone
- (208) 814-1600
- Fax
- (208) 814-1910
- NPI assigned
- Aug 3, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | PA60639841 | WA | |
| Family Medicine Physician | 207Q00000X | PA-965 | ID | Primary |
Addresses
Primary practice location
725 Pole Line Rd W
Twin Falls, ID 83301-5800
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-8866
Other practice location 1
4003 Creekside Loop
Yakima, WA 98908-3962
Phone (509) 746-4125
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID, UT, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Wisconsin School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bingham Memorial Hospital
Practice addresses (Care Compare)
315 W Idaho St
Blackfoot, ID 83221-1711
Phone (208) 782-3990
98 Poplar St
Blackfoot, ID 83221-1758
Phone (208) 785-4100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA965 | ID | MD | Family Medicine Physician |
| PA60639841 | WA | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yakima Valley Memorial Physicians | Current | Accepting new patients | |
| Ma Bo Inc | Family Medicine | Current | Accepting new patients |
| Yakima Valley Memorial Physicians | Current | Accepting new patients | |
| BMH Inc | Current | Accepting new patients | |
| Elite Anesthesia Associates | Past | Accepting new patients |
Locations
98 Poplar St
Blackfoot, ID 83221
Phone (208) 782-3763
1555 W Shoreline Dr
Ste 100
Boise, ID 83702
Phone (206) 953-3708
466 E 500 S
Ste 200
Salt Lake Cty, UT 84111
Phone (801) 485-5055
4003 Creekside Loop
Yakima, WA 98908
Phone (509) 248-3263
2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210
Interoperability endpoints
- bradlybrown@bmh.medalliesdirect.net
- https://api.platform.athenahealth.com/11894/brand/1/csg/1/fhir/r4
- https://api.platform.athenahealth.com/6289/brand/1/csg/1/fhir/r4
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Yakima, WA
- NPI 1306933940
-
- Critical Access Hospital
- Blackfoot, ID
- NPI 1982805271
-
- Otolaryngology Physician
- St George, UT
- NPI 1679733869
-
- Durable Medical Equipment & Medical Supplies
- Yakima, WA
- NPI 1366325870
-
- Certified Registered Nurse Anesthetist
- Orem, UT
- NPI 1922627975
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Blackfoot, ID
- NPI 1982805271
-
dba MultiCare Yakima Memorial Hospital
- General Acute Care Hospital
- Yakima, WA
- NPI 1053373480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789516800000",
"number": "1043598477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-381-8866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 POLE LINE RD W",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833015800",
"telephone_number": "208-814-1600",
"fax_number": "208-814-1910"
}
],
"practiceLocations": [
{
"address_1": "4003 Creekside Loop",
"address_purpose": "LOCATION",
"city": "Yakima",
"state": "WA",
"postal_code": "989083962",
"country_code": "US",
"telephone_number": "509-746-4125",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROWN",
"first_name": "BRADLY",
"middle_name": "KENNETH LEROY",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-03",
"last_updated": "2026-09-16",
"certification_date": "2026-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "WA",
"license": "PA60639841",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "PA-965",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.