Kevin Bradford, A.S. C.A.D.C

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

15094 Issued in IA

Practice address

1607 NW Prairie Lakes Dr
Unit 212
Ankeny, IA 50023-4819

Phone

(402) 840-7288

NPI assigned

Nov 18, 2015

Last updated

Nov 23, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1114391828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 NW PRAIRIE LAKES DR.UNIT 212",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "50023",
            "telephone_number": "402-840-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 NW PRAIRIE LAKES DR",
            "address_2": "UNIT 212",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500234819",
            "telephone_number": "402-840-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "KEVIN",
        "credential": "A.S.   C.A.D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "15094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Ankeny, IA
• Providers in Ankeny, IA by specialty
• Addiction (Substance Use Disorder) Counselor in Iowa

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

Verify at the official NPI Registry.