Bradford Nathanial Whitehead, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

71006859A Issued in IN

Practice address

1036 Sharon Dr
Jeffersonville, IN 47130-4522

Phone

(812) 280-2080

NPI assigned

Feb 7, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

TLBH WellnessGroup PAC ID 6204285760, 3 clinicians

Twin Lakes Counseling Services LLCGroup PAC ID 4082948070, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• TLBH Wellness

  • Rural Health Clinic/Center
  • Leitchfield, KY
  • NPI 1518553874

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Twin Lakes Counseling Services, LLC

  • Professional Counselor
  • Leitchfield, KY
  • NPI 1508100447
  Medicare reassignment Care Compare group NPD
• Onward Therapy LLC

  • Psychiatric/Mental Health Registered Nurse
  • Louisville, KY
  • NPI 1588402531
  NPD Authorized official
• Ataraxia Integrated Medicine and Wellness Corporation

  • Rural Health Clinic/Center
  • Leitchfield, KY
  • NPI 1578246229

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1063950335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 SHARON DR",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471304522",
            "telephone_number": "812-280-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 SHARON DR",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471304522",
            "telephone_number": "812-280-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "BRADFORD",
        "middle_name": "NATHANIAL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-07",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71006859A",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71006859A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Dawn Wheeler
• Olivia Wheeler
• Sharon Wheeles
• Kevin E. White, M.D.
• Stephanie White
• Gerri Whitworth, LMHC
• Denise Blair Wilburn
• Theresa Lynn Wilder, PHARM.D.
• Duncan Wiley, APRN
• Melissa Rene Wilkerson, APRN FNP-C

• Psychiatric/Mental Health Nurse Practitioner in Jeffersonville, IN
• Providers in Jeffersonville, IN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.