Bradley Chiropractic, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH10894 Issued in FL

Legal business name

BRADLEY CHIROPRACTIC, PLLC

Practice address

432 Lake St
Fulton, KY 42041-1531

Phone

(270) 705-3896

NPI assigned

Aug 20, 2013

Last updated

Aug 20, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mallory K Bradley, DCNPI 1538505755

Title

Owner

Phone

(270) 705-3896

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 1

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.

• Mallory K Bradley, D.C.

  • Chiropractor
  • Fulton, KY
  • NPI 1538505755
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376956800000",
    "number": "1275966715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 LAKE ST",
            "city": "FULTON",
            "state": "KY",
            "postal_code": "420411531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 LAKE ST",
            "city": "FULTON",
            "state": "KY",
            "postal_code": "420411531",
            "telephone_number": "270-705-3896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-20",
        "last_updated": "2013-08-20",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "MALLORY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-705-3896",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arcare (KentuckyCare58)
• Board of Education of Fulton Kentucky
• Abby Bomar
• Mallory K Bradley, D.C.
• Kimberly Dawn Brinkley, APRN
• Mary Burditt
• Elizabeth Jane Campbell, PHARMD
• Changes Rehabilitation LLC

• Chiropractor in Fulton, KY
• Providers in Fulton, KY by specialty
• Chiropractor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.