Active NPI
Patricia J Bradley, PSY.D
- Psychologist
- Devils Lake, ND
National Provider Identifier
1356651228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- ND438
- Practice address
- 200 Highway 2 SW
Devils Lake, ND 58301-3532 - Phone
- (701) 665-2200
- Fax
- (701) 665-2300
- NPI assigned
- Oct 13, 2010
- Last updated
- Nov 27, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | ND438 | ND | Primary |
Addresses
Primary practice location
200 Highway 2 SW
Devils Lake, ND 58301-3532
Mailing address
210 Hwy 2 W
Suite 10
Devils Lake, ND 58301
Phone (701) 662-1046
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND438 | ND | MD | Psychologist |
| 438 | ND | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543276800000",
"number": "1356651228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 HWY 2 W",
"address_2": "SUITE 10",
"city": "DEVILS LAKE",
"state": "ND",
"postal_code": "58301",
"telephone_number": "701-662-1046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HIGHWAY 2 SW",
"city": "DEVILS LAKE",
"state": "ND",
"postal_code": "583013532",
"telephone_number": "701-665-2200",
"fax_number": "701-665-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "PATRICIA",
"middle_name": "J",
"credential": "PSY.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-13",
"last_updated": "2018-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "ND",
"license": "ND438",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Devils Lake, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.