Mountain West Spine LLC

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

Legal business name

MOUNTAIN WEST SPINE LLC

Practice address

2960 E St Lukes St
Suite 200
Meridian, ID 83642-3506

Phone

(208) 992-5212

NPI assigned

Mar 12, 2024

Organization subpart

No

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

Authorized official

Name

William Bradley, MDNPI 1245273382

Title

Owner

Phone

(208) 992-5212

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Daniel Bradley, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Meridian, ID
  • NPI 1245273382
  Medicare reassignment NPD Authorized official
• Sara Wilson

  • Nurse Practitioner
  • Middleton, ID
  • NPI 1417338104
  Medicare reassignment NPD

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

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1982462008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 E ST LUKES ST",
            "address_2": "SUITE 200",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-992-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 E ST LUKES ST",
            "address_2": "SUITE 200",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423506",
            "telephone_number": "208-992-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN WEST SPINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-12",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-992-5212",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mountain Pine Dermatology, PLLC
• Mountain Valley Counseling LLC
• Mountain View Pointe Dental
• Mountain View Surgery Center
• Mountain West Medical Services PLLC
• Mountain West Sport and Spine Physical Therapy LLC
• Hannah Lynn Mower
• Rachael Ann Mower, RN
• Molly Moyer, COUI
• Mary L. Muckelroy, LCSW

• Orthopaedic Surgery of the Spine Physician in Meridian, ID
• Providers in Meridian, ID by specialty
• Orthopaedic Surgery of the Spine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.