Zachery M Brunson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-607 Issued in ID

Practice address

393 E 2ND N
Rexburg, ID 83440

Phone

(208) 356-5401

Fax

(208) 356-3111

NPI assigned

Jun 22, 2006

Last updated

Apr 13, 2020By 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

Other identifiers 1

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

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Madison Co Memorial HospitalGroup PAC ID 8123016367, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brunsoza@direct.madisonmemorial.org

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.

• Madison Co Memorial Hospital

  dba Madison Memorial Rexburg Medical Clinic

  • Family Medicine Physician
  • Rexburg, ID
  • NPI 1134592017
  Medicare reassignment Care Compare group NPD (past)
• Ashton Memorial, Inc.

  dba Ashton Living Center

  • Skilled Nursing Facility
  • Ashton, ID
  • NPI 1497756803
  NPD
• Madison Co Memorial Hospital

  dba Seasons Medical By Madison Memorial

  • Obstetrics & Gynecology Physician
  • Rexburg, ID
  • NPI 1073154266

  Family Medicine

  NPD
• Madison Co Memorial Hospital

  dba Rigby Medical Center

  • Family Medicine Physician
  • Rigby, ID
  • NPI 1356026280
  NPD
• Madison Co Memorial Hospital

  • General Acute Care Hospital
  • Rexburg, ID
  • NPI 1992747570
  NPD
• Ashton Memorial, Inc.

  dba Ashton Medical Clinic

  • Health Service Clinic/Center
  • Ashton, ID
  • NPI 1588991566
  NPD (past)
• Community Care, PLLC

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1003088782
  NPD (past)
• Community Council of Idaho, Inc.

  dba Rigby Community Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Rigby, ID
  • NPI 1710664834

  Family Medicine

  NPD (past)
• Medical Imaging Associates of Idaho Falls, Inc

  • Diagnostic Radiology Physician
  • Pocatello, ID
  • NPI 1740225531
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1447296785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E 2ND N",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401605",
            "telephone_number": "208-356-5401",
            "fax_number": "208-356-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 E 2ND N",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "83440",
            "telephone_number": "208-356-5401",
            "fax_number": "208-356-3111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2088 E 25th St",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834046490",
            "country_code": "US",
            "telephone_number": "208-542-3517",
            "fax_number": "208-524-9390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNSON",
        "first_name": "ZACHERY",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807432900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Lee Brown, NP-C
• Pamela Brown, LCPC
• Rosemary H Brown, FNP-C
• Michael Brunson, PHARMD
• Shelby Renee Brunson
• Bryce B. Thueson, O.D., PLLC (Today's Eye Care)
• Ehlana Buchanan, LPC
• Rayo Pascal Budge, LPC
• Jeremiah D Buehner, PA
• Brandon M Buhler, LMFT

• Medical Physician Assistant in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.