Active NPI
Bradford Daniel Withington, NP
- Nurse Practitioner
- Milwaukee, WI
National Provider Identifier
1255689642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4938-33
- Practice address
- 1027 N 9TH St
Milwaukee, WI 53233-1411 - Phone
- (414) 765-0606
- Fax
- (414) 765-0226
- NPI assigned
- Aug 16, 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4938-33 | WI | Primary |
Addresses
Primary practice location
1027 N 9TH St
Milwaukee, WI 53233-1411
Mailing address
413 N 2ND St
Unit 460
Milwaukee, WI 53203-3100
Phone (920) 254-6266
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161108001770 | WI | Order and Referring Only - Nurse Practitioner | 7214216688 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4938-33 | WI | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345075200000",
"number": "1255689642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 N 2ND ST",
"address_2": "UNIT 460",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532033100",
"telephone_number": "920-254-6266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1027 N 9TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532331411",
"telephone_number": "414-765-0606",
"fax_number": "414-765-0226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITHINGTON",
"first_name": "BRADFORD",
"middle_name": "DANIEL",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-16",
"last_updated": "2012-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "4938-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.