Individual provider Active NPI

Bradley Smith, FNP-BC

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1023442654
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5437-33 Issued in WI
Practice address
5408 W Burleigh St
Milwaukee, WI 53210-1624
Phone
(414) 362-8147
NPI assigned
Aug 30, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5437 WI
Family Nurse Practitioner 363LF0000X 5437-33 WI Primary

Addresses

Primary practice location

5408 W Burleigh St
Milwaukee, WI 53210-1624

Mailing address

285 N Janacek Rd
Brookfield, WI 53045-6102
Phone (262) 641-9050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150616000611 WI Practitioner - Nurse Practitioner 2264743335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6900 N Port Washington Rd
Milwaukee, WI 53217-3921
Phone (414) 270-8100

801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600

9252 N Green Bay Rd
FL 2
Brown Deer, WI 53209-1104
Phone (414) 270-8150

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5437WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Sep 1, 2023 Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Jun 21, 2015 Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc CurrentSince Jun 21, 2015 Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc Current Accepting new patients

Locations

7395 Solutions Ctr
Chicago, IL 60677

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

10101 S 27th St
Franklin, WI 53132
Phone (414) 325-4700

N112W15415 Mequon Rd
Germantown, WI 53022
Phone (262) 250-7800

6900 N Port Washington Rd
Glendale, WI 53217
Phone (414) 270-8100

4425 N Port Washington Rd
Glendale, WI 53212
Phone (414) 326-2218

5408 W Burleigh St
Milwaukee, WI 53210
Phone (414) 445-6520

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1023442654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 N JANACEK RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530456102",
            "telephone_number": "262-641-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5408 W BURLEIGH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101624",
            "telephone_number": "414-362-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRADLEY",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-30",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "5437",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5437-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.