Active NPI
Heather Lee Bradley, PHD
- Clinical Neuropsychologist
- Tallahassee, FL
National Provider Identifier
1093822876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PY6826
- Practice address
- 1408 N Piedmont Way
Tallahassee, FL 32308-7974 - Phone
- (850) 692-6326
- Fax
- (850) 692-6976
- NPI assigned
- Aug 25, 2006
- Sex
- Female
- Sole proprietor
- No
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 Neuropsychologist | 103G00000X | PY6826 | FL | Primary |
Addresses
Primary practice location
1408 N Piedmont Way
Tallahassee, FL 32308-7974
Mailing address
1408 N Piedmont Way
Tallahassee, FL 32308-7974
Phone (850) 692-6326
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 73127 | Other | FL | BLUE CROSS PROVIDER NUMBE |
| 591917016 | Other | FL | COMMERCIAL INSURANCE |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY6826 | FL | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387411200000",
"number": "1093822876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1408 N PIEDMONT WAY",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323087974",
"telephone_number": "850-692-6326",
"fax_number": "850-692-6976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1408 N PIEDMONT WAY",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323087974",
"telephone_number": "850-692-6326",
"fax_number": "850-692-6976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "HEATHER",
"middle_name": "LEE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-25",
"last_updated": "2013-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "FL",
"license": "PY6826",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER NUMBE",
"identifier": "73127",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL INSURANCE",
"identifier": "591917016",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.