Individual provider Active NPI

Weston Bradley

  • Pharmacist
  • Roswell, NM
National Provider Identifier
1164834982
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH0003655 Issued in NM
Practice address
2800 N Main St
Roswell, NM 88201-6500
Phone
(575) 623-0830
Fax
(575) 623-0827
NPI assigned
May 28, 2014
Last updated
May 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH0003655 NM Primary

Addresses

Primary practice location

2800 N Main St
Roswell, NM 88201-6500

Mailing address

2800 N Main St
Roswell, NM 88201-6500
Phone (575) 623-0830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PH0003655NMMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Farmer's Uptown Pharmacy, LLC Current Accepting new patients
Uptown Clinic LLC CurrentSince Oct 30, 2022 Accepting new patients

Locations

2800 N Main St
Roswell, NM 88201
Phone (575) 623-0830

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22931/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1164834982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N MAIN ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882016500",
            "telephone_number": "575-623-0830",
            "fax_number": "575-623-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N MAIN ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882016500",
            "telephone_number": "575-623-0830",
            "fax_number": "575-623-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "WESTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-28",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "PH0003655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.