Active NPI
Bradley Keffer
- Speech-Language Pathologist
- T Or C, NM
National Provider Identifier
1245575406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1582
- Practice address
- 1400 N Silver St
T Or C, NM 87901-1957 - Phone
- (575) 894-7855
- NPI assigned
- Nov 29, 2012
- Last updated
- Nov 29, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1582 | NM | Primary |
Addresses
Primary practice location
1400 N Silver St
T Or C, NM 87901-1957
Mailing address
1868 El Segundo TRL
Las Cruces, NM 88011-4032
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1582 | NM | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354147200000",
"number": "1245575406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1868 EL SEGUNDO TRL",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880114032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 N SILVER ST",
"city": "T OR C",
"state": "NM",
"postal_code": "879011957",
"telephone_number": "575-894-7855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEFFER",
"first_name": "BRADLEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-11-29",
"last_updated": "2012-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NM",
"license": "1582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in T Or C, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.