Individual provider Active NPI

Bradley R Stork, NP-C

  • Family Nurse Practitioner
  • Bismarck, ND
National Provider Identifier
1285675728
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R27167 Issued in ND
Practice address
310 N 9TH St
Bismarck, ND 58501-4515
Phone
(701) 530-8800
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R27167 ND Primary

Addresses

Primary practice location

310 N 9TH St
Bismarck, ND 58501-4515

Mailing address

310 N 9TH St
Bismarck, ND 58501-4515
Phone (701) 530-8800

Other identifiers 2

IdentifierTypeStateIssuer
1459578MedicaidND
500018668OtherNDMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091005000433 ND Practitioner - Nurse Practitioner 9638215692 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: bradleystork@tbjpc.allscriptsdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bone and Joint Center PC 40 clinicians

Practice addresses (Care Compare)

310 N 9TH St
Bismarck, ND 58501-4515
Phone (701) 946-7500

Hospital & facility affiliations

  • CHI St Alexius Health Hospital, Bismarck, ND, CCN 350002
  • Sakakawea Medical Center - Cah Hospital, Hazen, ND, CCN 351310

Merit-based Incentive Payment System (MIPS)

Final score
79.67 of 100Reported as group
Quality
80.89
Promoting interoperability
71
Improvement activities
40
Cost
75.49

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1285675728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014515",
            "telephone_number": "701-530-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014515",
            "telephone_number": "701-530-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORK",
        "first_name": "BRADLEY",
        "middle_name": "R",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R27167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1459578",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "500018668",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.