Individual provider Active NPI

Bradford Grant Williams

  • Psychologist
  • Medina, OH
National Provider Identifier
1225297336
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3335 Issued in OH
Practice address
246 Northland Dr
Medina, OH 44256-1533
Phone
(330) 723-9600
Fax
(330) 722-1446
NPI assigned
Jun 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3335 OH Primary

Addresses

Primary practice location

246 Northland Dr
Medina, OH 44256-1533

Mailing address

246 Northland Dr
Medina, OH 44256-1533
Phone (330) 723-9600

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3335OHMDPsychologist

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": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212537600000",
    "number": "1225297336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 NORTHLAND DR",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442561533",
            "telephone_number": "330-723-9600",
            "fax_number": "330-722-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 NORTHLAND DR",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442561533",
            "telephone_number": "330-723-9600",
            "fax_number": "330-722-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRADFORD",
        "middle_name": "GRANT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "3335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; 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.