Individual provider Active NPI

Natasha Ann Braddy, ARNP

  • Adult Health Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1083338370
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1-180685 Issued in AL
Practice address
2812 Hartford Hwy Ste 1
Dothan, AL 36305-4927
Phone
(334) 712-1170
Fax
(334) 460-8391
NPI assigned
Sep 29, 2022
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1-180685 AL Primary
Gerontology Nurse Practitioner 363LG0600X 180685 AL

Addresses

Primary practice location

2812 Hartford Hwy Ste 1
Dothan, AL 36305-4927

Mailing address

206 Crabapple CT
Rehobeth, AL 36301-9237
Phone (334) 796-4869

Other practice location 1

1970 Andrews Ave
Ozark, AL 36360-3726
Phone (334) 774-1555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20240326002999 AL Practitioner - Nurse Practitioner 3375980352 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-180685ALMDAdult Health Nurse Practitioner
180685ALMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Remedy Behavioral Health, LLC CurrentSince Jul 30, 2024 Accepting new patients
Shoals NP Homecare, LLC Current Accepting new patients
Signify Health, LLC CurrentSince Feb 22, 2025 Accepting new patients

Locations

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280

1609 Mockingbird Ct
Ste B
Florence, AL 35630
Phone (256) 320-7778

1001 S Jackson Hwy
Sheffield, AL 35660
Phone (256) 320-7778

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 3

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": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1083338370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 CRABAPPLE CT",
            "city": "REHOBETH",
            "state": "AL",
            "postal_code": "363019237",
            "telephone_number": "334-796-4869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 HARTFORD HWY STE 1",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363054927",
            "telephone_number": "334-712-1170",
            "fax_number": "334-460-8391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1970 Andrews Ave",
            "address_purpose": "LOCATION",
            "city": "Ozark",
            "state": "AL",
            "postal_code": "363603726",
            "country_code": "US",
            "telephone_number": "334-774-1555",
            "fax_number": "334-443-0213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADDY",
        "first_name": "NATASHA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-29",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-180685",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AL",
            "license": "180685",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.