Active NPI
John Michael Bradley, PH.D.
- Clinical Psychologist
- Harahan, LA
National Provider Identifier
1356490155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 947
- Practice address
- 1529 River Oaks Rd W
Harahan, LA 70123-2162 - Phone
- (504) 813-2842
- Fax
- (504) 734-8826
- NPI assigned
- Jan 9, 2007
- Last updated
- Feb 6, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 947 | LA | Primary |
Addresses
Primary practice location
1529 River Oaks Rd W
Harahan, LA 70123-2162
Mailing address
3721 Palmyra St.
New Orleans, LA 70119
Phone (504) 813-2842
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050615000003 | LA | Practitioner - Clinical Psychologist | 1153365754 | Practice locations: Elmwood, LA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
621 Distributors Row
Elmwood, LA 70123-3219
Phone (504) 813-2842
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391644800000",
"number": "1356490155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3721 PALMYRA ST.",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "70119",
"telephone_number": "504-813-2842",
"fax_number": "504-734-8826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1529 RIVER OAKS RD W",
"city": "HARAHAN",
"state": "LA",
"postal_code": "701232162",
"telephone_number": "504-813-2842",
"fax_number": "504-734-8826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "JOHN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2014-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "LA",
"license": "947",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harahan, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.