Jennifer Therese Bradford, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0102203986 Issued in VA

Practice address

10623 Crestwood Dr
Manassas, VA 20109-3433

Phone

(703) 361-7131

Fax

(703) 330-2065

NPI assigned

Jul 13, 2012

Last updated

Jan 27, 2016By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Crestwood Pediatric Associates PC

  • Pediatrics Physician
  • Manassas, VA
  • NPI 1629034897
  NPD (past)
• Trusted Doctors LLC

  • Pediatrics Physician
  • Fairfax, VA
  • NPI 1083793525
  NPD (past)
• Pediatrics of Westmoreland, LTD

  • Pediatrics Physician
  • Greensburg, PA
  • NPI 1912099193
  NPD (past)

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1073868261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10366 BARRINGTON PARK CIR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201106767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10623 CRESTWOOD DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093433",
            "telephone_number": "703-361-7131",
            "fax_number": "703-330-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "JENNIFER",
        "middle_name": "THERESE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP10042728",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0102203986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teressa Bowman, M.A, QMHP
• Joyce Boyce
• David Boyd
• Sydney Boyer, PA-C
• Keith B Boykin, MD
• Joshua Brady
• Sarah A Brady, NP-C
• Braley and Thompson, Inc.
• Dewayne Dee Bramlett, OTR
• Rebecca Anne Laree Branham

• Pediatrics Physician in Manassas, VA
• Providers in Manassas, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; 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.