Individual provider Active NPI

Bradley A Friend, DC

  • Chiropractor
  • Morgantown, WV
National Provider Identifier
1316027832
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
690 Issued in WV
Practice address
179 Hanalei Dr Ste 3
Morgantown, WV 26508-4303
Phone
(304) 598-3000
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 690 WV Primary

Addresses

Primary practice location

179 Hanalei Dr Ste 3
Morgantown, WV 26508-4303

Mailing address

179 Hanalei Dr Ste 3
Morgantown, WV 26508-4303
Phone (304) 598-3000

Other identifiers 1

IdentifierTypeStateIssuer
3200010000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080122000048 WV Practitioner - Chiropractic 9931280591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Group practices
Elite Chiropractic PLLCGroup PAC ID 9931646197, 3 clinicians

Practice addresses (Care Compare)

179 Hanalei Dr
Suite 3
Morgantown, WV 26508-4303
Phone (304) 598-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
690WVMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Chiropractic PLLC Chiropractor CurrentSince Jul 1, 2024 Accepting new patients

Locations

179 Hanalei Dr
#3
Morgantown, WV 26508
Phone (304) 598-3000

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1316027832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 HANALEI DR STE 3",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265084303",
            "telephone_number": "304-598-3000",
            "fax_number": "304-777-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 HANALEI DR STE 3",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265084303",
            "telephone_number": "304-598-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEND",
        "first_name": "BRADLEY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3200010000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.