Brady Theobald Inc

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

BRADY THEOBALD INC

Practice address

1220 E 3900 S
Salt Lake City, UT 84124-1327

Phone

(800) 748-4868

Fax

(801) 733-5872

NPI assigned

Jan 2, 2007

Last updated

Aug 22, 2020By 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

Brady Theobald, CRNA

Title

President

Phone

(800) 748-4868

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346307006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1954 FORT UNION BLVD",
            "address_2": "101",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216800",
            "telephone_number": "800-748-4868",
            "fax_number": "801-733-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241327",
            "telephone_number": "800-748-4868",
            "fax_number": "801-733-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADY THEOBALD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THEOBALD",
        "authorized_official_first_name": "BRADY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-748-4868",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rulon Ralph Bradley, M.D.
• Russell Bradley, MD
• Stephen K Bradley, MD
• Emily Bradshaw
• Zoe Nicole Bradshaw
• Bruce Ryan Brady, M.D.
• Cariann Brady, DNP
• Dalton K. Brady, MD
• Danielle Brady, M.D.
• Evan Edgar Brady, D.C.

• Certified Registered Nurse Anesthetist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Certified Registered Nurse Anesthetist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.