NPI age
— years
Enumerated 2026-01-23
● Active Type 2 · Organization
Brandy M Bates, Llc
Brandy M Bates, Llc is 1 of 36 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Bates
Owner/provider
Last NPPES update
2026-01-23
Source: monthly bulk 2026-05
How this organization compares
Across 36 active clinic/center providers in Idaho.
NPI age
0 years
↓ 15 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2026 → 2026
2026-01Enumerated in NPPES
2026
2026
Where they practice
Primary practice location
2434 S Fairway Dr
Pocatello, ID 832012372
Mailing address
2434 S Fairway Dr
Pocatello, ID 832012372
Authorized official
Brandy M Bates, DMSC, PA-C, CAQ-PSYC
Owner/provider
📞 2088519151
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Brandy Bates, PA-C Physician Assistant NPI 1487886560
Specialties
-
Clinic/Center PrimaryAn entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 601809507 |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Haven Complete Wellness Services
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.