Active NPI
Kyla Elise Bradley
- Pharmacist
- Byram, MS
National Provider Identifier
1043986474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E-100347
- Practice address
- 5780 Terry Rd
Byram, MS 39272-9745 - Phone
- (601) 346-2553
- NPI assigned
- Aug 17, 2021
- Last updated
- Aug 17, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-100347 | MS | Primary |
Addresses
Primary practice location
5780 Terry Rd
Byram, MS 39272-9745
Mailing address
6975 Osprey Dr
Ocean Springs, MS 39564-4201
Phone (228) 627-3948
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rxm.10694@store.walgreens.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-100347 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
5780 Terry Rd
Byram, MS 39272
Phone (601) 346-2553
Interoperability endpoints
- rxm.10694@store.walgreens.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629158400000",
"number": "1043986474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6975 OSPREY DR",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "395644201",
"telephone_number": "228-627-3948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5780 TERRY RD",
"city": "BYRAM",
"state": "MS",
"postal_code": "392729745",
"telephone_number": "601-346-2553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "KYLA",
"middle_name": "ELISE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-17",
"last_updated": "2021-08-17",
"certification_date": "2021-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-100347",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rxm.10694@store.walgreens.com",
"affiliation": "N",
"endpointDescription": "Store email address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "5780 Terry Rd",
"city": "Byram",
"state": "MS",
"country_code": "US",
"postal_code": "392729745",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Byram, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.