NPIMap

Individual provider Active NPI

Bradley Wescott Terry, D.O.

  • Family Medicine Physician
  • Weiser, ID
National Provider Identifier
1871973198
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-1122 Issued in ID
Practice address
360 E Liberty St
Weiser, ID 83672-2261
Phone
(208) 549-4424
NPI assigned
Jun 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9832809-1204 UT
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X O-1122 ID Primary

Addresses

Primary practice location

360 E Liberty St
Weiser, ID 83672-2261

Mailing address

475 W 940 N
Provo, UT 84604-3301
Phone (801) 357-7940

Other practice location 1

475 W 940 N
Provo, UT 84604-3301
Phone (801) 357-7940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180522000676 ID Practitioner - Family Practice 7214223510 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weiser Valley Hospital DistrictGroup PAC ID 5294704276, 60 clinicians

Practice addresses (Care Compare)

360 E Liberty St
Weiser, ID 83672-2261

645 E 5TH St
Weiser, ID 83672-2202
Phone (208) 549-3152

Hospital & facility affiliations

  • Horizon Home Health West Home health agency, Caldwell, ID, CCN 137135
  • Weiser Memorial Hospital Hospital, Weiser, ID, CCN 131307
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071
  • Saint Alphonsus Medical Center Ontario Hospital, Ontario, OR, CCN 380052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Weiser Valley Hospital District CurrentSince Jun 4, 2018 Accepting new patients
Weiser Valley Hospital District Family Medicine CurrentSince Jun 4, 2018 Accepting new patients
Weiser Valley Hospital District CurrentSince Jul 28, 2025 Accepting new patients

Locations

360 E Liberty St
Weiser, ID 83672
Phone (208) 414-1124

645 E 5th St
Weiser, ID 83672
Phone (208) 549-0370

360 E Liberty St
#B
Weiser, ID 83672
Phone (208) 549-4424

360 E Liberty St
#A
Weiser, ID 83672
Phone (208) 549-4424

Organizations & group practices 4

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1871973198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 W 940 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043301",
            "telephone_number": "801-357-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E LIBERTY ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836722261",
            "telephone_number": "208-549-4424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 W 940 N",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846043301",
            "country_code": "US",
            "telephone_number": "801-357-7940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TERRY",
        "first_name": "BRADLEY",
        "middle_name": "WESCOTT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9832809-1204",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-1122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weiser, ID

Sources for this page

Verify at the official NPI Registry.