Silver Angels of Tennessee - Bradley, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

SILVER ANGELS OF TENNESSEE - BRADLEY, LLC

Practice address

2990 Westside Dr NW
Cleveland, TN 37312-3506

Phone

(423) 728-1707

NPI assigned

Jul 16, 2012

Organization subpart

Yes

Parent organization

SILVER ANGELS OF TENNESSEE, LLCAs reported in NPPES

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

Authorized official

Name

Mr. John Harrison

Title

Cfo

Phone

(502) 568-7800

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1255686200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 BLUEGRASS PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992361",
            "telephone_number": "502-568-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 WESTSIDE DR NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123506",
            "telephone_number": "423-728-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER ANGELS OF TENNESSEE - BRADLEY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SILVER ANGELS OF TENNESSEE, LLC",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-568-7800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Shull, LCSW
• Tabitha A. Shumate, BA
• Ahmadur Rahman Siddiqui
• Adrianna Payne Sifford, LPC-MHSP
• Scott A Sikorski, L.AC.
• Grant Pegram Simmons, M.D.
• James Clarence Simmons, PSY.D
• Haley Simpson, RRT
• Joshua Kyle Simpson, LMSW
• Harrison G. Sims III, M.D.

• In Home Supportive Care Agency in Cleveland, TN
• Providers in Cleveland, TN by specialty
• In Home Supportive Care Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.

Verify at the official NPI Registry.