Kenneth Lee Bradley Jr.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Practice address

138 Tera MNR
Wintersville, OH 43953-3955

Phone

(740) 381-1957

NPI assigned

Nov 16, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1225631005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 TERA MNR",
            "city": "WINTERSVILLE",
            "state": "OH",
            "postal_code": "439533955",
            "telephone_number": "740-381-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 TERA MNR",
            "city": "WINTERSVILLE",
            "state": "OH",
            "postal_code": "439533955",
            "telephone_number": "740-381-1957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "KENNETH",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4101851",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "(740)-381-3679",
            "affiliation": "N",
            "address_1": "138 Tera Mnr",
            "city": "Wintersville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "439533955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lindsay Blake, PMHNP
• Cameron Lamont Bonds
• Jodi Lynn Bonomo, COTA
• Melissa Ann Booth
• David Bowden II, D.C.
• Amber A Brooks, HIS
• Jennifer Nicole Brown, DPT
• Thomas R. Brown, D.D.S., F.A.G.D.
• Melissa Buksa, FNP-C
• Jessica Renee Burge

• Home Health Agency in Wintersville, OH
• Providers in Wintersville, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.