Individual provider Active NPI

Aiyana Bradford, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Johnstown, PA
National Provider Identifier
1306718242
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ15430100 Issued in NJ
Practice address
124 Donald LN
Johnstown, PA 15904-2815
Phone
(814) 915-4539
NPI assigned
Sep 20, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP032005 PA
Psychiatry Physician 2084P0800X SP032005 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ15430100 NJ Primary

Addresses

Primary practice location

124 Donald LN
Johnstown, PA 15904-2815

Mailing address

PO Box 432
Primos Secane, PA 19018-0432
Phone (610) 580-5180

Other practice location 1

100 Bowman Dr Lowr Level3
Voorhees, NJ 08043-9612
Phone (856) 355-7118

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abradford329865@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20260422003300 NJ Practitioner - Nurse Practitioner 0648747048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2351 The by Way
Morrow, GA 30260-1441

301 Lippincott Dr
Marlton, NJ 08053-4178

43 S Ridge CT
Ridgefield, CT 06877-5420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP032005PAMDPsychiatry Physician
26NJ15430100NJMDPsychiatric/Mental Health Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1758326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1306718242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 432",
            "city": "PRIMOS SECANE",
            "state": "PA",
            "postal_code": "190180432",
            "telephone_number": "610-580-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 DONALD LN",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159042815",
            "telephone_number": "814-915-4539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Bowman Dr Lowr Level3",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439612",
            "country_code": "US",
            "telephone_number": "856-355-7118",
            "fax_number": "856-325-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "AIYANA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-20",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP032005",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "SP032005",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15430100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abradford329865@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Lowr Level3",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.