Teirza D Bristow, ARNP is a medicare enrolled "Nurse Practitioner - Primary Care" in Kellogg, Idaho. She graduated from nursing school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Shoshone Medical Center and her current practice location is
25 Jacobs Gulch Rd, Kellogg, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 784-4612.
Teirza D Bristow is licensed to practice in Idaho (license number 59228) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1700363348.
Provider's Profile
| Full Name | Teirza D Bristow |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 6 Years |
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| Location | 25 Jacobs Gulch Rd, Kellogg, Idaho |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Teirza D Bristow graduated from nursing school in 2018
NPI Data:
- NPI Number: 1700363348
- Provider Enumeration Date: 07/26/2018
- Last Update Date: 07/26/2018
Medicare PECOS Information:
- PECOS PAC ID: 7315290830
- Enrollment ID: I20181031001602
Medical Identifiers
Medical identifiers for Teirza D Bristow such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1700363348 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LP2300X | Nurse Practitioner - Primary Care | 59228 (Idaho) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Shoshone Medical Center | 6103739107 | 11 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Teirza D Bristow allows following entities to bill medicare on her behalf.
| Entity Name | Shoshone Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1043215437
PECOS PAC ID: 6103739107
Enrollment ID: O20050113001084 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Teirza D Bristow is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Teirza D Bristow, ARNP
25 Jacobs Gulch Rd,
Kellogg, ID 83837-2023
Ph: (208) 784-4612 | Teirza D Bristow, ARNP
25 Jacobs Gulch Rd,
Kellogg, ID 83837-2023
Ph: (208) 784-4612 |
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