Active NPI
Robert W Bradford, LISW-CP
- Clinical Social Worker
- Aiken, SC
National Provider Identifier
1093030561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6310
- Practice address
- 410 University Pkwy
Suite 2300
Aiken, SC 29801-6807 - Phone
- (803) 335-1219
- Fax
- (803) 335-1689
- NPI assigned
- Mar 29, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6310 | SC | Primary |
Addresses
Primary practice location
410 University Pkwy
Suite 2300
Aiken, SC 29801-6807
Mailing address
410 University Pkwy
Suite 2300
Aiken, SC 29801-6807
Phone (803) 335-1219
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SW1000 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6310 | SC | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephen J Enns | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/11228/brand/1/csg/1/fhir/r4
Organizations & group practices 1
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.
-
- Child & Adolescent Psychiatry Physician
- Aiken, SC
- NPI 1942666839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423008000000",
"number": "1093030561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 UNIVERSITY PKWY",
"address_2": "SUITE 2300",
"city": "AIKEN",
"state": "SC",
"postal_code": "298016807",
"telephone_number": "803-335-1219",
"fax_number": "803-335-1689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 UNIVERSITY PKWY",
"address_2": "SUITE 2300",
"city": "AIKEN",
"state": "SC",
"postal_code": "298016807",
"telephone_number": "803-335-1219",
"fax_number": "803-335-1689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADFORD",
"first_name": "ROBERT",
"middle_name": "W",
"credential": "LISW-CP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-29",
"last_updated": "2015-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "SC",
"license": "6310",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SW1000",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Aiken, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.