Active NPI
Siyakorn Bradford, NURSE PRACTITIONER
- Adult Health Nurse Practitioner
- Cleveland, OH
National Provider Identifier
1336561216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 15362-NP
- Practice address
- 11100 Euclid Ave
Mailstop:Han 6095
Cleveland, OH 44106-1716 - Phone
- (216) 844-6338
- NPI assigned
- Jan 13, 2014
- Last updated
- Jan 15, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 15362-NP | OH | Primary |
Addresses
Primary practice location
11100 Euclid Ave
Mailstop:Han 6095
Cleveland, OH 44106-1716
Mailing address
8055 Mayfield Rd
Ste 105
Chesterland, OH 44026-2447
Phone (440) 214-8027
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | siyakornbradford@uhps.allscriptsdirect.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240808004740 | FL | Order and Referring Only - Nurse Practitioner | 2668604497 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15362-NP | OH | MD | Adult Health Nurse Practitioner |
Interoperability endpoints
- sbradford27735@ehrdirect.uhhospitals.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610668800000",
"number": "1336561216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8055 MAYFIELD RD",
"address_2": "STE 105",
"city": "CHESTERLAND",
"state": "OH",
"postal_code": "440262447",
"telephone_number": "440-214-8027",
"fax_number": "216-201-8173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11100 EUCLID AVE",
"address_2": "MAILSTOP:HAN 6095",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061716",
"telephone_number": "216-844-6338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADFORD",
"first_name": "SIYAKORN",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-13",
"last_updated": "2021-01-15",
"certification_date": "2021-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "OH",
"license": "15362-NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "siyakornbradford@uhps.allscriptsdirect.net",
"affiliation": "N",
"address_1": "4510 Richmond Rd",
"city": "Warrensville Heights",
"state": "OH",
"country_code": "US",
"postal_code": "441285757",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.