Bradley Shore, MD, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

BRADLEY SHORE, MD, LLC

Practice address

107 E Shankland Ave
Jennings, LA 70546-4709

Phone

(866) 546-6643

Fax

(337) 824-4199

NPI assigned

Aug 23, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Bradley S Shore, M.D.

Title

Owner

Phone

(504) 905-2728

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1345680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345680000000",
    "number": "1083962021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E SHANKLAND AVE",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705464709",
            "telephone_number": "866-546-6643",
            "fax_number": "337-824-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E SHANKLAND AVE",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705464709",
            "telephone_number": "866-546-6643",
            "fax_number": "337-824-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY SHORE, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-23",
        "last_updated": "2012-08-23",
        "status": "A",
        "authorized_official_last_name": "SHORE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-905-2728",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla N Boudreaux, LPC-S
• Lisa D Boudreaux, PT
• Victoria Miller Boudreaux, APRN, FNP-C
• Allison P Boulet, MPT
• Sally Bourque, MPT
• Charles Bradley, MHS
• Gwendolyn Marie Braum, MHP
• Jill Angelle Breaux, APRN, FNP-C
• Kathryn J Brennan, MSLP
• Brian Cranford Wilder Apmc

• Diagnostic Radiology Physician in Jennings, LA
• Providers in Jennings, LA by specialty
• Diagnostic Radiology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2012; 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.