Bradley Brent Lowder, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

76808 Issued in ID

Practice address

2850 Olympus Dr
Pocatello, ID 83201-2271

Phone

(208) 239-2273

Fax

(208) 239-3677

NPI assigned

Mar 12, 2019

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PHS Ambulatory Services LLCGroup PAC ID 6507213402, 6 clinicians

Sterling Provider GroupGroup PAC ID 2264773373, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blowder884339@ahs.direct-ci.com
• Direct secure messaging: blowder@hardinmemorial.gwaydirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• PHS Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Pocatello, ID
  • NPI 1306524152
  Medicare reassignment Care Compare group NPD
• Sterling Provider Group

  • Urgent Care Clinic/Center
  • Idaho Falls, ID
  • NPI 1205300407
  Medicare reassignment Care Compare group NPD
• Urgent Care Associates PLLC

  • Preferred Provider Organization
  • Idaho Falls, ID
  • NPI 1609046408
  NPD
• Sterling Provider Group

  • Urgent Care Clinic/Center
  • Butte, MT
  • NPI 1871220038
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pocatello Hospital LLC

  • Rehabilitation Hospital Unit
  • Pocatello, ID
  • NPI 1144262114
  Care Compare affiliation
• Pocatello Hospital LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1790751055
  Care Compare affiliation

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1528526241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 OLYMPUS DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012271",
            "telephone_number": "208-239-2237",
            "fax_number": "208-239-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 OLYMPUS DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012271",
            "telephone_number": "208-239-2273",
            "fax_number": "208-239-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWDER",
        "first_name": "BRADLEY",
        "middle_name": "BRENT",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-12",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "76808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Longshot Enterprises, Inc.
• Katie Looper
• Nicole Lopez
• Cory Bryant Louie
• Griffin Loutzenhiser, PHARMD
• Kenneth Ray Lowther, FNP-C
• Juan Lucero, LCSW-38062
• Rebekah Lucero
• Holli Ludwig, LMSW
• Michael Lloyd Ludwig, LCSW-33464

• Family Nurse Practitioner in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.