Active NPI
Bryce Elwin Anderson
- Emergency Medicine Physician
- Glen Dale, WV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 31944
- Practice address
- 800 Wheeling Ave
Glen Dale, WV 26038-1697 - Phone
- (048) 453-2113
- Fax
- (304) 843-3202
- NPI assigned
- Mar 23, 2020
- Last updated
- Jun 5, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | M-17103 | ID | |
| Emergency Medicine Physician | 207P00000X | 31944 | WV | Primary |
Addresses
Primary practice location
800 Wheeling Ave
Glen Dale, WV 26038-1697
Mailing address
PO Box 9149
Morgantown, WV 26506-9149
Phone (304) 293-2436
Other practice location 1
1 Medical Center Dr
Morgantown, WV 26506-1200
Phone (304) 293-2436
Other practice location 2
1224 8th St
Rupert, ID 83350-1599
Phone (208) 436-0481
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121
777 Hospital Way
Pocatello, ID 83201-5175
Phone (208) 239-1000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-17103 | ID | MD | Emergency Medicine Physician |
| 31944 | WV | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minidoka Memorial Hospital | Emergency Medicine | Current | Accepting new patients |
| Minidoka Memorial Hospital | Current | Accepting new patients | |
| Cep America LLC | Emergency Medicine | Current | Accepting new patients |
| Cep America, LLC | Emergency Medicine | Current | Accepting new patients |
| Rocky Mountain Physician Group LLC | Emergency Medicine | Current | Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125
1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152
777 Hospital Way
Pocatello, ID 83201
Phone (208) 239-1000
1224 8th St
Rupert, ID 83350
Phone (208) 434-8236
Organizations & group practices 5
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.
-
- Critical Access Hospital
- Rupert, ID
- NPI 1679553531
-
- Emergency Medicine Physician
- Pocatello, ID
- NPI 1851808133
-
- Emergency Medicine Physician
- Fort Lauderdale, FL
- NPI 1700747946
-
- Emergency Care Clinic/Center
- Rupert, ID
- NPI 1134333495
Emergency Medicine
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Portneuf Rehabilitation Center
- Rehabilitation Hospital Unit
- Pocatello, ID
- NPI 1144262114
-
dba Portneuf Medical Center
- General Acute Care Hospital
- Pocatello, ID
- NPI 1790751055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749081600000",
"number": "1639706591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9149",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265069149",
"telephone_number": "304-293-2436",
"fax_number": "304-293-6702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 WHEELING AVE",
"city": "GLEN DALE",
"state": "WV",
"postal_code": "260381697",
"telephone_number": "048-453-2113",
"fax_number": "304-843-3202"
}
],
"practiceLocations": [
{
"address_1": "1 Medical Center Dr",
"address_purpose": "LOCATION",
"city": "Morgantown",
"state": "WV",
"postal_code": "265061200",
"country_code": "US",
"telephone_number": "304-293-2436",
"fax_number": "304-293-6702",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1224 8th St",
"address_purpose": "LOCATION",
"city": "Rupert",
"state": "ID",
"postal_code": "833501599",
"country_code": "US",
"telephone_number": "208-436-0481",
"fax_number": "208-436-6038",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDERSON",
"first_name": "BRYCE",
"middle_name": "ELWIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-23",
"last_updated": "2025-06-05",
"certification_date": "2025-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "ID",
"license": "M-17103",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WV",
"license": "31944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glen Dale, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.