Martha Y Brantley-Jackson

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Practice address

25400 Alessandro Blvd Ste 101
Moreno Valley, CA 92553-4319

Phone

(951) 570-0043

NPI assigned

May 24, 2019

Last updated

May 24, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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.

• Quinn Community Outreach Corporation

  dba Qcoc

  • Health Maintenance Organization
  • Moreno Valley, CA
  • NPI 1447815659
  NPD (past)

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1396302261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25400 ALESSANDRO BLVD STE 101",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534319",
            "telephone_number": "951-570-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25400 ALESSANDRO BLVD STE 101",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534319",
            "telephone_number": "951-570-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANTLEY-JACKSON",
        "first_name": "MARTHA",
        "middle_name": "Y",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-24",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anta L Bradley, L.V.N.
• Leah Miyagishima Bradley, OD
• Jenee Bradshaw
• Shawna Bramel, LCSW
• Jessica A Brandon
• Juan M Bretado
• Bright Angels at Heart
• Clarissa May Briones, PT DPT
• Raina Brommer
• Madelene Brooks, P.A.

• Preferred Provider Organization in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; 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.