| Brandi Ann Bartholomew, NP | |
|
267 N Canyon Dr, Gooding, ID 83330-5500 | |
| (208) 934-4433 | |
| (208) 934-4442 |
| Full Name | Brandi Ann Bartholomew |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 2 Years |
| Location | 267 N Canyon Dr, Gooding, Idaho |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437835287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 77808 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| North Canyon Medical Center | Gooding, ID | Hospital |
| St Lukes Magic Valley Medical Center | Twin falls, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| North Canyon Medical Center Inc | 0941371439 | 53 |
| St Lukes Clinic Llc | 1052217478 | 294 |
| Entity Name | St Lukes Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
| Entity Name | North Canyon Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609046671 PECOS PAC ID: 0941371439 Enrollment ID: O20090409000304 |
| Entity Name | St Lukes Clinic-treasure Valley Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
| Mailing Address | Practice Location Address |
|---|---|
| Brandi Ann Bartholomew, NP 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Brandi Ann Bartholomew, NP 267 N Canyon Dr, Gooding, ID 83330-5500 Ph: (208) 934-4433 |
Mrs. Nicole D Odell, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 267 N Canyon Dr, Gooding, ID 83330 Phone: 208-934-4446 Fax: 208-934-4442 |