NPIMap

Organization Active NPI

John a. Bradford M.D., P.a.

  • Specialist
  • Bangor, ME
National Provider Identifier
1255667226
Registry record updated Oct 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
011526 Issued in ME
Legal business name
JOHN A. BRADFORD M.D., P.A.
Practice address
151 Broadway
Bangor, ME 04401-5207
Phone
(207) 945-9461
Fax
(207) 945-3241
NPI assigned
Oct 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2009

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

Authorized official

Name
Dr. John Additon Bradford, MDNPI 1093791964
Title
Owner/President
Phone
(207) 945-9461

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 011526 ME Primary

Addresses

Primary practice location

151 Broadway
Bangor, ME 04401-5207

Mailing address

151 Broadway
Bangor, ME 04401-5207
Phone (207) 945-9461

Other identifiers 1

IdentifierTypeStateIssuer
116170000MedicaidME

National Provider Directory

National Provider Directory

Locations

151 Broadway
Bangor, ME 04401
Phone (207) 945-9441

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256601600000",
    "number": "1255667226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015207",
            "telephone_number": "207-945-9461",
            "fax_number": "207-945-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015207",
            "telephone_number": "207-945-9461",
            "fax_number": "207-945-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN A. BRADFORD M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-27",
        "last_updated": "2009-10-27",
        "status": "A",
        "authorized_official_last_name": "BRADFORD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ADDITON",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "207-945-9461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "ME",
            "license": "011526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116170000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; 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.