Individual provider Active NPI

Laura Bradigan

  • Psychiatric/Mental Health Nurse Practitioner
  • Compton, CA
National Provider Identifier
1407464522
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95014597 Issued in CA
Practice address
121 S Long Beach Blvd
Compton, CA 90221-3423
Phone
(855) 645-0033
NPI assigned
Jul 15, 2020
Last updated
Feb 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95014597 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95014597 CA Primary

Addresses

Primary practice location

121 S Long Beach Blvd
Compton, CA 90221-3423

Mailing address

121 S Long Beach Blvd
Compton, CA 90221-3423
Phone (629) 610-1555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230112002347 CA Practitioner - Nurse Practitioner 9133599921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Roads Foundation, IncGroup PAC ID 2961722558, 57 clinicians

Practice addresses (Care Compare)

121 S Long Beach Blvd
Compton, CA 90221-3423
Phone (310) 627-5850

4525 E Atherton St
Long Beach, CA 90815-3700
Phone (562) 961-0155

4800 E Los Coyotes Diagonal
Long Beach, CA 90815-2897
Phone (562) 506-1313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95014597CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Roads Foundation, Inc. CurrentSince Oct 6, 2022 Accepting new patients
The Roads Foundation, Inc Past Accepting new patients

Locations

121 S Long Beach Blvd
Compton, CA 90221
Phone (310) 627-5850

4525 E Atherton St
Long Beach, CA 90815
Phone (562) 961-0155

4525 E Atherton St
Fl 2
Long Beach, CA 90815
Phone (562) 422-2240

4800 E Los Coyotes Diagonal
Long Beach, CA 90815
Phone (310) 627-5850

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1407464522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S LONG BEACH BLVD",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902213423",
            "telephone_number": "629-610-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S LONG BEACH BLVD",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902213423",
            "telephone_number": "855-645-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADIGAN",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95014597",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95014597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Compton, CA

Sources for this page

Verify at the official NPI Registry.