Colleen Ann Bradford, PNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2017036482 Issued in MO

Practice address

456 N New Ballas Rd
Ste 304
Saint Louis, MO 63141-6831

Phone

(314) 567-6868

Fax

(314) 567-0578

NPI assigned

Aug 28, 2013

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

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Washington University

  • Pediatrics Physician
  • Saint Louis, MO
  • NPI 1942949482
  Medicare reassignment NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1669405544
  NPD (past)
• George V Chandy,M.D., S.C.

  • Specialist
  • Milwaukee, WI
  • NPI 1215045034
  NPD (past)

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1164856993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 N NEW BALLAS RD",
            "address_2": "STE 304",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416831",
            "telephone_number": "314-567-6868",
            "fax_number": "314-567-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 N NEW BALLAS RD",
            "address_2": "STE 304",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416831",
            "telephone_number": "314-567-6868",
            "fax_number": "314-567-0578"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1035 Bellevue Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Richmond Heights",
            "state": "MO",
            "postal_code": "631171844",
            "country_code": "US",
            "telephone_number": "314-815-8610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "COLLEEN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-28",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2017036482",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2017036482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "456 N New Ballas Rd",
            "address_2": "STE 304",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416831",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR-API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1035 Bellevue Ave Ste 400",
            "city": "Richmond Heights",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631171844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbradford496813@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cbradford496813@direct-ehr-ssmhc.com",
            "address_1": "1035 Bellevue Ave Ste 400",
            "city": "Richmond Heights",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631171844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laura Bradfield, RD, LD
• Emile Bradford-Taylor, REGISTERED NURSE
• Alissa Monique Bradford
• Brittnay Tamaris Bradford
• Charles Bradford, FNP-BC
• Debbie Bradford, PHARMD
• Krystal K Bradford
• Lashanda Bradford
• Shelia Latrese Bradford
• Timothy Bradford

• Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.