Bradford Terrace LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

16030961 Issued in GU

Legal business name

BRADFORD TERRACE LLC

Practice address

808 Colley Rd
Starke, FL 32091-4215

Phone

(904) 964-6220

Fax

(904) 964-4446

NPI assigned

Mar 15, 2006

Last updated

Apr 25, 2012By 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

Ms. Donna Marsh

Title

CF0

Phone

(386) 255-1054

Specialties & licenses 1

Addresses

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1306815147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 COLLEY RD",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320914215",
            "telephone_number": "904-964-6220",
            "fax_number": "904-964-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 COLLEY RD",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320914215",
            "telephone_number": "904-964-6220",
            "fax_number": "904-964-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADFORD TERRACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "MARSH",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "CF0",
        "authorized_official_telephone_number": "386-255-1054",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GU",
            "license": "16030961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bill Marchese, PL
• Bio-Medical Applications of Florida, Inc. (Bma of Starke)
• Alexandra Nicole Blanton
• Bradford Emergency Group LLC
• Bradford Family Dentistry, PL
• Kasey Bradley
• Sarah C Bryan
• Felicia Bryant
• Courtney E Buchan, ARNP
• Doneshia Mackey Cadet, APRN, FNP-BC

• Skilled Nursing Facility in Starke, FL
• Providers in Starke, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.