Active NPI
Laurie L Bradley, DDS
- Dentist
- San Antonio, TX
National Provider Identifier
1104914571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 16480
- Practice address
- 7703 Floyd Curl Dr
San Antonio, TX 78229 - Phone
- (210) 567-6405
- Fax
- (210) 567-2844
- NPI assigned
- Oct 11, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 16480 | TX | Primary |
Addresses
Primary practice location
7703 Floyd Curl Dr
San Antonio, TX 78229
Mailing address
PO Box 40397
San Antonio, TX 78229-3900
Phone (210) 567-6405
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 976188 | Other | UNITED CONCORDIA | |
| 834609 | Other | BLUE CROSS BLUE SHIELD |
Other names 1
- Laurie Ann Lovell
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 25, 2016 through Feb 25, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16480 | TX | MD | Mental Health Counselor |
Interoperability endpoints
- lbradley309521@direct.ochin.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104914571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 40397",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782293900",
"telephone_number": "210-567-6405",
"fax_number": "210-567-2844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7703 FLOYD CURL DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78229",
"telephone_number": "210-567-6405",
"fax_number": "210-567-2844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "LAURIE",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "16480",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "976188",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "834609",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LAURIE",
"last_name": "LOVELL",
"middle_name": "ANN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.