Organization Active NPI

Dawn Bradley Arnp PLLC

  • Family Nurse Practitioner
  • Ft Myers, FL
National Provider Identifier
1366828931
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
DAWN BRADLEY ARNP PLLC
Practice address
3056 Champion Ring Rd
Ft Myers, FL 33905
Phone
(941) 206-5200
NPI assigned
Aug 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Authorized official

Name
Dawn Bradley, ARNPNPI 1801192919
Title
Owner
Phone
(239) 292-4001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

3056 Champion Ring Rd
Ft Myers, FL 33905

Mailing address

14671 Triple Eagle CT
Fort Myers, FL 33912-1706
Phone (239) 489-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150929000518 FL Part B Supplier - Clinic/Group Practice 4385952118 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

3056 Champion Ring Rd
Fort Myers, FL 33905

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1366828931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14671 TRIPLE EAGLE CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121706",
            "telephone_number": "239-489-1400",
            "fax_number": "239-489-1927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3056 CHAMPION RING RD",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "33905",
            "telephone_number": "941-206-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAWN BRADLEY ARNP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-06",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-292-4001",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.