Randy E Bradford, LSCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4238 Issued in KS

Practice address

550 Pope Ave
Attn: Credentials
Fort Leavenworth, KS 66027-2332

Phone

(913) 684-6562

NPI assigned

Dec 20, 2010

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 4, 2024.

{
    "created_epoch": "1292803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1265735989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 POPE AVE",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660272332",
            "telephone_number": "913-758-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 POPE AVE",
            "address_2": "ATTN: CREDENTIALS",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660272332",
            "telephone_number": "913-684-6562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "RANDY",
        "middle_name": "E",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-20",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "4238",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Bilik, RDH
• Robert Allen Bischoff, PH.D.
• Sherry Blakney-Johnson, LPN
• Tracy Katherine Bono-Johnson, L.P.N.
• Diane Marie Booth
• Jennifer Klein Brewster, PT, DPT
• Stephanie Renee Brooks, DO
• Jason Brozek, PHARMD, JD
• Kenya Sade Bryant, PSYD
• Dave Alan Buchheim, M.ED., PTA

• All providers in Fort Leavenworth, KS
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.