NPIMap

Individual provider Active NPI

Estena Patricia Bradley, NP- WOMENS HEALTH

  • Women's Health Nurse Practitioner
  • Oxford, NC
National Provider Identifier
1225009996
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
79052 Issued in NC
Practice address
1209 SE Industry Dr
Oxford, NC 27565
Phone
(252) 492-8576
Fax
(252) 492-7464
NPI assigned
Jan 30, 2006
Last updated
Apr 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 79052 NC Primary

Addresses

Primary practice location

1209 SE Industry Dr
Oxford, NC 27565

Mailing address

PO Box 1541
Oxford, NC 27565-1541
Phone (252) 492-8576

Other identifiers 1

IdentifierTypeStateIssuer
500018286OtherNCRR MEDICARE

Other names 1

  • Estena B Henderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040218000143 NC Practitioner - Nurse Practitioner 7810882909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 Charles Rollins Rd
Henderson, NC 27536-2882

1209 SE Industry Dr
Oxford, NC 27565-5023
Phone (252) 492-8576

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
79052NCMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Maria Parham Physician Practices, LLC Current Accepting new patients
DLP Maria Parham Physician Practices LLC CurrentSince Apr 1, 2015 Accepting new patients
DLP Maria Parham Physician Practices, LLC CurrentSince Apr 1, 2015 Accepting new patients
Premier Womens Health Professionals, PA Past Accepting new patients
DLP Maria Parham Physician Practices, LLC Past Accepting new patients

Locations

120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773

511 Ruin Creek Rd
Ste 101
Henderson, NC 27536
Phone (252) 436-0440

568 Ruin Creek Rd
Ste 1
Henderson, NC 27536
Phone (252) 438-7102

568 Ruin Creek Rd
Ste 6
Henderson, NC 27536
Phone (252) 436-1380

1209 SE Industry Dr
Oxford, NC 27565
Phone (252) 492-8576

Interoperability endpoints

  • Direct secure messaging: estena.bradley.1@20247.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1225009996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1541",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275651541",
            "telephone_number": "252-492-8576",
            "fax_number": "252-492-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 SE INDUSTRY DR",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "27565",
            "telephone_number": "252-492-8576",
            "fax_number": "252-492-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "ESTENA",
        "middle_name": "PATRICIA",
        "credential": "NP- WOMENS HEALTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NC",
            "license": "79052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "500018286",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ESTENA",
            "last_name": "HENDERSON",
            "middle_name": "B",
            "credential": "RNCGONP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oxford, NC

Sources for this page

Verify at the official NPI Registry.