Brandon Christopher Bader

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

2800 Freeway Blvd Ste 204
Minneapolis, MN 55430-1751

Phone

(763) 412-1996

Fax

(763) 292-5653

NPI assigned

Jun 17, 2020

Sex

Male

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1154947901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 FREEWAY BLVD STE 204",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554301751",
            "telephone_number": "763-412-1996",
            "fax_number": "763-292-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 FREEWAY BLVD STE 204",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554301751",
            "telephone_number": "763-412-1996",
            "fax_number": "763-292-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADER",
        "first_name": "BRANDON",
        "middle_name": "CHRISTOPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "874647200",
            "identifier": "874647200",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "BrooklynCenter",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Brooklyn Center",
            "address_1": "2800 Freeway Blvd Ste 204",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554301751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lilia Bacu, MSN, NP
• Sujan Badal, MD
• Angelica Badaru
• Elizabeth Bade, MD
• Jayme Lorraine Bender Baden, LMFT
• Kory John Badertscher, OTR, ATP
• Nicholas Anthony Badhwa
• Piyush NA Badola, LADC
• Sabina Rose Badola
• Huda Siyad Badri

• Community Health Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Community Health Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.