Kathleen Quintana Bradley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-06215 Issued in NC

Practice address

1523 Elizabeth Ave.
Suite 200
Charlotte, NC 28204

Phone

(704) 910-1402

Fax

(704) 910-1506

NPI assigned

Jul 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathleen Marie Quintana Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Allergy Asthma & Immunology Relief, PA

  • Allergy & Immunology (Internal Medicine) Physician
  • Charlotte, NC
  • NPI 1548511314
  NPD (past)
• Dynamic Health Carolinas, PLLC

  • General Practice Physician
  • Charlotte, NC
  • NPI 1124693338
  NPD (past)
• Maeve E. O'Connor MD, PA

  • Allergy & Immunology (Internal Medicine) Physician
  • Charlotte, NC
  • NPI 1922340132
  NPD (past)

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513209600000",
    "number": "1225480551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 ELIZABETH AVE.",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-910-1402",
            "fax_number": "704-910-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 ELIZABETH AVE.",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-910-1402",
            "fax_number": "704-910-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "KATHLEEN",
        "middle_name": "QUINTANA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2017-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "QUINTANA",
            "middle_name": "MARIE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• April Bradley, RN, MSN
• Davis Burr Bradley, DPT
• De'Erik Lamontae Bradley, LCSWA
• Javontae Bradley
• Kathi C Bradley, LPCA
• Melissa Marie Bradley, OTR
• Noah Bradley
• Rebecca B Bradley, DDS
• Ronnie Joe Bradley, LCAS
• Stacy Denise Bradley, PSY.D.

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; 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.