Jessica Bradburn, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4060 Issued in SC

Practice address

7580 Charlotte Hwy
Suite 800
Indian Land, SC 29707-7801

Phone

(803) 380-4310

Fax

(803) 380-4312

NPI assigned

Oct 5, 2015

Last updated

Oct 5, 2015By the provider in NPPES

Sex

Female

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)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cultivate Health Chiropractic

  • Chiropractor
  • Indian Land, SC
  • NPI 1932579810
  Authorized official Same address or phone

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1114397098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 CHARLOTTE HWY",
            "address_2": "SUITE 800",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297077801",
            "telephone_number": "803-380-4310",
            "fax_number": "803-380-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 CHARLOTTE HWY",
            "address_2": "SUITE 800",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297077801",
            "telephone_number": "803-380-4310",
            "fax_number": "803-380-4312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBURN",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Indian Land, SC
• Providers in Indian Land, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.