Ebony S Bradford

Primary specialty

ContractorTaxonomy code 171W00000X

License

23424503 Issued in TX

Practice address

3204 Sharpview LN
Dallas, TX 75228-6060

Phone

(469) 939-7851

NPI assigned

May 28, 2013

Last updated

Mar 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Foundation Plus Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Foundationplus

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Dallas, TX
  • NPI 1356655096
  NPD (past)

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1346687613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 SHARPVIEW LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752286060",
            "telephone_number": "469-939-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 SHARPVIEW LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752286060",
            "telephone_number": "469-939-7851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "EBONY",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-28",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "TX",
            "license": "23424503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FOUNDATION",
            "last_name": "PLUS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alysia Braddock
• Amanda Nichole Braddock, MD
• Randi M Bradfield
• Bradford L Romans MD PA
• Ashley Bradford, FNP-C
• Emeri Jean Bradford, PA-C
• Jennifer W. Bradford, PHD
• Katrina Marie Bradford, M.D.
• Rhonda Bradford, NP
• Shelby B Bradford, MCN, RD, LD

• Contractor in Dallas, TX
• Providers in Dallas, TX by specialty
• Contractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.