Karissa Braden, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209021939 Issued in IL

Practice address

1640 N Damen Ave
Chicago, IL 60647-5553

Phone

(312) 219-2230

NPI assigned

Feb 20, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Mount Sinai School of Medicine

  dba Mount Sinai Manhasset Medical

  • Internal Medicine Physician
  • Manhasset, NY
  • NPI 1144659749
  NPD (past)

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1013456334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475553",
            "telephone_number": "312-219-2230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8041 Newman Ave",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926477034",
            "country_code": "US",
            "telephone_number": "714-500-0224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "489 5th Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100176145",
            "country_code": "US",
            "telephone_number": "212-530-2288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADEN",
        "first_name": "KARISSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-20",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005480",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342228",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209021939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yolanda Marcia Bracy, D.T., LBSI
• William S Bradbury, MD
• Vanessa R Bradden, LMFT
• Gloria Tan Braddock
• Matthew Thomas Braddock, MD
• Shelby Marisa Braden, PMH-DNP
• Warren Braden Sr., ED.D.
• Bradford Chiropractic and Associates PC
• Ebony Bradford-Thomas
• Danielle Bradford

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.