Gail Ann Bradley, RD, LD
Individual provider Active NPI Registered Dietitian · Reno, NV
NPI 1376575522 · NPPES record last updated Feb 22, 2024
Key facts
- NPI
- 1376575522
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 40354-DI-0 (NV)
- Practice address
- 720 Tahoe St Ste C
Reno, NV 89509-1700 - Phone
- (775) 772-6849
- Fax
- (833) 371-1467
- NPI assigned
- Jul 7, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201028002490 | NV | Practitioner - Registered Dietitian Or Nutrition Professional | 7911317193 | Practice locations: Reno, NV |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40354-DI-0 | NV | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 40354-DI-0 | NV | Yes |
Addresses
Primary practice location
720 Tahoe St Ste C
Reno, NV 89509-1700
Mailing address
2410 West Moana Lane
Reno, NV 89509-7801
Phone (775) 772-6840
Other practice location 1
2410 W Moana Ln Ste C
Reno, NV 89509-7801
Phone (775) 772-6840
Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.