Brandy M Bates LLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

BRANDY M BATES LLC

Doing business as

Haven Complete Wellness Services

Practice address

2434 S Fairway Dr
Pocatello, ID 83201-2372

Phone

(208) 851-9151

Fax

(208) 977-0029

NPI assigned

Jan 23, 2026

Last updated

Jul 15, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brandy M Bates, DMSC, PA-C, CAQ-PSYCNPI 1487886560

Title

Owner/Provider

Phone

(208) 851-9151

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Haven Complete Wellness Services Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brandy M Bates, PA-C

  • Medical Physician Assistant
  • Pocatello, ID
  • NPI 1487886560
  NPD Authorized official

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

{
    "created_epoch": "1769126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784073600000",
    "number": "1184573032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2434 S FAIRWAY DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012372",
            "telephone_number": "208-851-9151",
            "fax_number": "208-977-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 S FAIRWAY DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012372",
            "telephone_number": "208-851-9151",
            "fax_number": "208-977-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDY M BATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-23",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "208-851-9151",
        "authorized_official_credential": "DMSC, PA-C, CAQ-PSYC"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601809507",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haven Complete Wellness Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Bradley, LMT
• Mendi Ann Bradley, LMT
• Branch Management LLC
• Branch Management LLC
• Brandon a West, DO, PLLC (West Family Medicine)
• Spencer Bray, DDS
• Steven Jeff Bray, DPM
• Bridgeway Psychological and Counseling Services PLLC
• Bright Tomorrows Child Advocacy Center
• Bright Tomorrows, Incorporated

• Geriatric Medicine (Family Medicine) Physician in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Geriatric Medicine (Family Medicine) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.