Leah Bradford

Individual provider Active NPI Licensed Practical Nurse · Independence, OH

NPI 1003425372 · NPPES record last updated Jul 23, 2020

Key facts

NPI
1003425372
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
144361 (OH)
Practice address
4700 Rockside Rd Ste 100
Independence, OH 44131-2148
Phone
(216) 750-2600
NPI assigned
Jul 23, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
144361OHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Viaquest Hospice, LLC Past
since Aug 2, 2020
Accepting new patients
Viaquest Home Health of Ohio, LLC Past
since Aug 2, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 144361 OH Yes

Addresses

Primary practice location

4700 Rockside Rd Ste 100
Independence, OH 44131-2148

Mailing address

4700 Rockside Rd Ste 100
Independence, OH 44131-2148
Phone (216) 750-2600

Other identifiers

IdentifierTypeStateIssuer
2910854MedicaidOH

Other providers in Independence, OH

All providers in Independence, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.