Individual provider Active NPI

Sidney Worrell Bradley, FNP-C

  • Nurse Practitioner
  • Morehead City, NC
National Provider Identifier
1124868070
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5020133 Issued in NC
Practice address
3106 Arendell St
Morehead City, NC 28557-3202
Phone
(252) 808-2500
NPI assigned
May 29, 2024
Last updated
May 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5020133 NC Primary

Addresses

Primary practice location

3106 Arendell St
Morehead City, NC 28557-3202

Mailing address

2695 L T Hardee Rd # a
Greenville, NC 27858-7703
Phone (919) 922-5845

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241009000063 NC Practitioner - Nurse Practitioner 9133650534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Open Water Medical, PAGroup PAC ID 2961314315, 6 clinicians

Practice addresses (Care Compare)

1620 Live Oak St
Suite C
Beaufort, NC 28516-1583
Phone (252) 728-5737

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Open Water Medical, PA CurrentSince Aug 8, 2024 Accepting new patients
Open Water Medical, PA CurrentSince Aug 8, 2024 Accepting new patients

Locations

1620 Live Oak St
Ste C
Beaufort, NC 28516
Phone (252) 728-5737

1620C Live Oak St
Beaufort, NC 28516
Phone (252) 728-5737

3106 Arendell St
Morehead City, NC 28557
Phone (252) 808-2500

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1124868070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 L T HARDEE RD # A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278587703",
            "telephone_number": "919-922-5845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 ARENDELL ST",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285573202",
            "telephone_number": "252-808-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "SIDNEY",
        "middle_name": "WORRELL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5020133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

Verify at the official NPI Registry.