Bradford Emergency Group LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

BRADFORD EMERGENCY GROUP LLC

Practice address

922 E Call St
Starke, FL 32091-3616

Phone

(904) 368-2300

Fax

(304) 368-2306

NPI assigned

Jan 3, 2017

Last updated

Jan 3, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisha Falk

Title

VP of Contracting

Phone

(337) 354-1221

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483401600000",
    "number": "1003351818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 E CALL ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320913616",
            "telephone_number": "904-368-2300",
            "fax_number": "304-368-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADFORD EMERGENCY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-01-03",
        "status": "A",
        "authorized_official_last_name": "FALK",
        "authorized_official_first_name": "LISHA",
        "authorized_official_title_or_position": "VP OF CONTRACTING",
        "authorized_official_telephone_number": "337-354-1221"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bibco Inc (Back & Neck Pain Clinic)
• Nichole M Bigay
• Bill Marchese, PL
• Bio-Medical Applications of Florida, Inc. (Bma of Starke)
• Alexandra Nicole Blanton
• Bradford Family Dentistry, PL
• Bradford Terrace LLC
• Kasey Bradley
• Sarah C Bryan
• Felicia Bryant

• Emergency Medicine Physician in Starke, FL
• Providers in Starke, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.