Bradley Robert Dispense, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

673D MDG
5955 Zeamer Avenue
Jber, AK 99506

Phone

(907) 580-2376

NPI assigned

May 11, 2011

Last updated

May 25, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1356633218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673D MDG",
            "address_2": "5955 ZEAMER AVENUE",
            "city": "JBER",
            "state": "AK",
            "postal_code": "99506",
            "telephone_number": "907-580-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673D MDG",
            "address_2": "5955 ZEAMER AVENUE",
            "city": "JBER",
            "state": "AK",
            "postal_code": "99506",
            "telephone_number": "907-580-2376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISPENSE",
        "first_name": "BRADLEY",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-11",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Derade, IDMT
• Cheyenne Marie Deraymond, MS, LAT, ATC
• Ian Cirasunda Dettman, PHARMD
• Michael Guilio Difelice, DMD
• Nikia Diggins
• Ross William Dodge, MD
• Joshua W Donart, D.O.
• Anthony Joseph Donigian, MD
• Ever Amity Dotimas
• Cassandra L Doucet, IDMT

• Physician Assistant in Jber, AK
• Providers in Jber, AK by specialty
• Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.