Individual provider Active NPI

Amy Leigh Bradley, FNP-C

  • Family Nurse Practitioner
  • Mesquite, TX
National Provider Identifier
1346265451
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP115072 Issued in TX
Practice address
1210 N Galloway Ave
Mesquite, TX 75149-2438
Phone
(972) 216-5152
Fax
(972) 216-5154
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP115072 TX Primary

Addresses

Primary practice location

1210 N Galloway Ave
Mesquite, TX 75149-2438

Mailing address

1210 N Galloway Ave
Mesquite, TX 75149-2438
Phone (972) 216-2152

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070222000684 TX Practitioner - Nurse Practitioner 7911009865 Reassigns benefits to 1 organization
Practice locations: Booker, TX

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Salma Mazhar M.D. P.a.Group PAC ID 9133267917, 4 clinicians

Practice addresses (Care Compare)

1210 N Galloway Ave
Mesquite, TX 75149-2438
Phone (972) 216-5152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP115072TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Salma Mazhar M.D. P.a. CurrentSince Apr 1, 2019 Accepting new patients
Booker Hospital District Past Accepting new patients

Locations

1210 N Galloway Ave
Mesquite, TX 75149
Phone (972) 216-5152

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2235/brand/1/csg/1/fhir/r4
  • Direct secure messaging: amy.dunn.1@2235.direct.athenahealth.com

Organizations & group practices 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1346265451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 N GALLOWAY AVE",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751492438",
            "telephone_number": "972-216-2152",
            "fax_number": "972-216-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 N GALLOWAY AVE",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751492438",
            "telephone_number": "972-216-5152",
            "fax_number": "972-216-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "AMY",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP115072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.