Individual provider Active NPI

Bradly Ely, DNP CCRN

  • Critical Care Medicine Registered Nurse
  • Northfield, MN
National Provider Identifier
1336050814
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
1910953 Issued in MN
Practice address
118 5TH St E
Northfield, MN 55057-2569
Phone
(612) 245-0037
NPI assigned
Sep 15, 2026
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 1910953 MN Primary

Addresses

Primary practice location

118 5TH St E
Northfield, MN 55057-2569

Mailing address

118 5TH St E
Northfield, MN 55057-2569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1789430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1336050814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 5TH ST E",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 5TH ST E",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572569",
            "telephone_number": "612-245-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELY",
        "first_name": "BRADLY",
        "name_prefix": "Dr.",
        "credential": "DNP CCRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-15",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MN",
            "license": "1910953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.