Karen Mary Brady, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS005273L Issued in PA

Practice address

1205 Grampian Blvd
Suite 1D
Williamsport, PA 17701-1978

Phone

(570) 320-7880

Fax

(570) 320-7882

NPI assigned

Mar 8, 2006

Last updated

Oct 19, 2011By 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 2

Addresses

Other names 1

• Karen Kolodziejczak Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

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.

• Susquehanna Physician Services

  dba Susquehanna Health Medical Group

  • Family Medicine Physician
  • South Williamsport, PA
  • NPI 1780631226
  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1154399178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "address_2": "SUITE 1K",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 GRAMPIAN BLVD",
            "address_2": "SUITE 1D",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011978",
            "telephone_number": "570-320-7880",
            "fax_number": "570-320-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "KAREN",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "OS005273L",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS005273L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "KOLODZIEJCZAK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark Boyles, BSL
• Daniel D Bozza, D.M.D.
• Patricia J Bozza, D.M.D.
• Aaron Ben Bradley, DMD
• Timothy Albert Bradley, PA-C
• Colin R. Branton, DMD
• Shawn Ryan Branton, D.M.D.
• Susan Ann Branton, MD
• Rodney J. Bratton, P.T.
• Christina Gasperine Breining, CRNP

• Dermatology Physician in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.