Katherine Elaine Bradley, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0017138087 Issued in VA

Practice address

615 Volunteer Parkway
Bristol, TN 37620

Phone

(423) 989-3223

NPI assigned

Oct 4, 2006

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

Other identifiers 6

Other names 1

• Katherine Elaine Yeary Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

Practice roles

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.

• Mark a. Bradley

  • Internal Medicine Physician
  • Weber City, VA
  • NPI 1487740049

  Family

  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410480000000",
    "number": "1154416329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1642 SNOWFLAKE RD",
            "city": "GATE CITY",
            "state": "VA",
            "postal_code": "242514142",
            "telephone_number": "423-963-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 VOLUNTEER PARKWAY",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "37620",
            "telephone_number": "423-989-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "KATHERINE",
        "middle_name": "ELAINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2014-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0017138087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4046961",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4401061",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "4100703",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN0103",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "020684999",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA3103",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "YEARY",
            "middle_name": "ELAINE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adrienne Lynne Bowman, DO
• Blaine Bowman, PHARMD
• Robin Elaine Bowman, N.P.
• Gary C Boyle, M.D.
• John Christopher Braddock, LPC
• Michael Barton Bradley, M.D.
• Brandon M. Cole, LPC, MHSP, PLLC
• Jim Carroll Brasfield, M.D.
• Samuel Lucas Brashears, MD
• Breast Prostheses & Orthotics Inc

• Family Nurse Practitioner in Bristol, TN
• Providers in Bristol, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; 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.