West Jefferson Family Health

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

ID-197 Issued in ID

Legal business name

WEST JEFFERSON FAMILY HEALTH

Practice address

39 N. 8TH W
Saint Anthony, ID 83445

Phone

(208) 419-6423

Fax

(208) 379-3520

NPI assigned

Apr 17, 2007

Last updated

Feb 17, 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

Brett W Zundel, PA-CNPI 1730222365

Title

Owner/Provider

Phone

(208) 419-6423

Specialties & licenses 1

Addresses

Other identifiers 3

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.

• Brett W Zundel, P.A-C

  • Medical Physician Assistant
  • Saint Anthony, ID
  • NPI 1730222365
  NPD (past) Authorized official

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1295951382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 N. 8TH W",
            "city": "SAINT ANTHONY",
            "state": "ID",
            "postal_code": "83445",
            "telephone_number": "208-419-6423",
            "fax_number": "208-379-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 N. 8TH W",
            "city": "SAINT ANTHONY",
            "state": "ID",
            "postal_code": "83445",
            "telephone_number": "208-419-6423",
            "fax_number": "208-379-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST JEFFERSON FAMILY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A",
        "authorized_official_last_name": "ZUNDEL",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "208-419-6423",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "ID-197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010006458",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805130800",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "PAYL7",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Upper Valley Community Health Services Inc (Grand Peaks Pharmacy)
• Upper Valley Community Health Services Inc (Grand Peaks Medical)
• Desiree Wade, LPC
• Shauna A Wasden, LMSW
• Spencer Emery Webb, LCSW
• Trevor Glade Wilde, D.O.
• Jenny Rickell Willmore, P.A.-C.
• Ryan G Willmore, PA-C
• Beth Winegar, LCSW
• Tara Lyanne Wood, LMT

• Physician Assistant in Saint Anthony, ID
• Providers in Saint Anthony, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.