Jill Margret Bradway

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101002179 Issued in MI

Practice address

1095 Medical Park Dr SE
Grand Rapids, MI 49546-3685

Phone

(616) 588-9210

NPI assigned

Jun 3, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1003474362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11099 WILDLIFE DR SE",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "493318824",
            "telephone_number": "517-256-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 MEDICAL PARK DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463685",
            "telephone_number": "616-588-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADWAY",
        "first_name": "JILL",
        "middle_name": "MARGRET",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101002179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louise Bradley
• Sarah Catherine Bradley, PA
• Sarah Elizabeth Bradley, FNP
• Macy Jo Bradshaw, PHARMD
• Siddeequa Moneek Bradshaw, MSN, APRN, FNP-C
• Ann Brady, LMSW
• Catherine A Brady
• Kristy Lynn Brady
• Randall Lee Brady, PA
• Justine Braford, BS

• Speech-Language Pathologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.