Individual provider Active NPI

Robert Roland Bradford III, CRNA

  • Certified Registered Nurse Anesthetist
  • Camp Lejeune, NC
National Provider Identifier
1124860408
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
7463 Issued in NC
Practice address
100 Brewster Blvd
Camp Lejeune, NC 28547-2575
Phone
(910) 450-4357
NPI assigned
Jun 10, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 7463 NC Primary

Addresses

Primary practice location

100 Brewster Blvd
Camp Lejeune, NC 28547-2575

Mailing address

212 Elm CT
Northbrook, IL 60062-1239
Phone (816) 550-3794

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241206003638 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779019286 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sarmc Anesthesia Specialist LLC 48 clinicians
Carolinaeast Medical Center 67 clinicians

Practice addresses (Care Compare)

1144 N Rd St
Elizabeth City, NC 27909-3473
Phone (252) 335-0531

2000 Neuse Blvd
New Bern, NC 28560-3449
Phone (252) 633-8111

Hospital & facility affiliations

  • Sentara Albemarle Medical Center Hospital, Elizabeth City, NC, CCN 340109
  • Carolina East Medical Center Hospital, New Bern, NC, CCN 340131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinaeast Medical Center CurrentSince Dec 2, 2024 Accepting new patients
Sarmc Anesthesia Specialist LLC CurrentSince Feb 1, 2025 Accepting new patients
Carolinaeast Medical Center Nurse Anesthetist, Certified Registered CurrentSince Dec 2, 2024 Accepting new patients

Locations

1144 N Road St
Elizabeth Cty, NC 27909
Phone (252) 384-4610

2000 Neuse Blvd
New Bern, NC 28560
Phone (252) 633-8104

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1124860408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 ELM CT",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621239",
            "telephone_number": "816-550-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472575",
            "telephone_number": "910-450-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "ROBERT",
        "middle_name": "ROLAND",
        "name_suffix": "III",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-10",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "7463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Lejeune, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.