Bradley Booth

Primary specialty

DriverTaxonomy code 172A00000X

Practice address

V538 County Road 4a
Liberty Center, OH 43532-8512

Phone

(419) 966-6384

NPI assigned

Jul 20, 2022

Last updated

Jul 20, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• 4A Housing LLC

  • Transportation Broker
  • Liberty Center, OH
  • NPI 1689390882
  NPD Authorized official

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1376278721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "V538 COUNTY ROAD 4A",
            "city": "LIBERTY CENTER",
            "state": "OH",
            "postal_code": "435328512",
            "telephone_number": "419-966-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "V538 COUNTY ROAD 4A",
            "city": "LIBERTY CENTER",
            "state": "OH",
            "postal_code": "435328512",
            "telephone_number": "419-966-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "BRADLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 4A Housing LLC
• Alanis Arrizola
• Pamela Born
• Toni Brewer
• Megan Browder
• Sara E Bullock, RN
• Brittney Creps

• Driver in Liberty Center, OH
• Providers in Liberty Center, OH by specialty
• Driver in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.