Bradley Martin, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

76908 Issued in ID

Practice address

358 Cheney Dr W Ste 101a
Twin Falls, ID 83301-6484

Phone

(208) 515-2273

Fax

(208) 515-2274

NPI assigned

Jul 29, 2020

Last updated

May 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meridian Advanced Psychiatry , LLCGroup PAC ID 8628490711, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bradley.martin@maph.eclinicaldirectplus.com

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.

• Meridian Advanced Psychiatry , LLC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Meridan, ID
  • NPI 1609412683
  Medicare reassignment Care Compare group NPD
• Spek Diagnostics, Inc

  • Dermatopathology (Pathology) Physician
  • Garden City, ID
  • NPI 1376261040
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1114536737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 CHENEY DR W STE 101A",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016484",
            "telephone_number": "208-515-2273",
            "fax_number": "208-515-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 CHENEY DR W STE 101A",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016484",
            "telephone_number": "208-515-2273",
            "fax_number": "208-515-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BRADLEY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-29",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "76908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chester C Mardis, LCPC
• Maria C Marez, OD
• Marla Dawn Corporation
• Kristen Marr
• Shiree Gloria Marsh, RN
• Karen M Martinat, LCSW
• Edward Justin Martinez
• Susan M Marzolf, M.D.
• Steven Lee Maschek, CNP
• Bryan C. Mason, MD

• Psychiatric/Mental Health Nurse Practitioner in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Psychiatric/Mental Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.

Verify at the official NPI Registry.