Gerald Alfred Bracete, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

21862 Issued in SC

Practice address

4500 8TH Division Rd
Columbia, SC 29207-5700

Phone

(803) 751-6418

NPI assigned

May 30, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Gerald Alfred Bracete Collazo Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1073005724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 OCTOBER GLORY DR",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290167638",
            "telephone_number": "787-557-8952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 8TH DIVISION RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292075700",
            "telephone_number": "803-751-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACETE",
        "first_name": "GERALD",
        "middle_name": "ALFRED",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "21862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GERALD",
            "last_name": "BRACETE COLLAZO",
            "middle_name": "ALFRED",
            "prefix": "MR.",
            "credential": "FNP-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Cierra Latreece Brabham, LPC, LCMHC
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• Michelle Brack, APRN
• Lisa Bracken
• Melanie Anne Brackey, PT, DPT
• Sally Roberts Braden, LCSW

• Family Nurse Practitioner in Columbia, SC
• Providers in Columbia, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.