Lisa Ann Bradley

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704297194 Issued in MI

Practice address

130 N Sherman St
Leslie, MI 49251-9409

Phone

(517) 205-2500

NPI assigned

Aug 2, 2021

Last updated

Aug 8, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Ann Ellis Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lbradley455459@direct.hfhs.org

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.

• Wa Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1629000708
  Medicare reassignment Care Compare group NPD
• W.a. Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1366988347

  Family

  NPD
• W.a. Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD
• W.a. Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Internal Medicine Physician
  • Jackson, MI
  • NPI 1699212803
  NPD (past)
• Wa Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Emergency Medicine Physician
  • Jackson, MI
  • NPI 1265487722
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• W.a. Foote Memorial Hospital

  dba Henry Ford Allegiance Health

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1053403402
  Care Compare affiliation

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1417620741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 SPRING ARBOR RD STE 200",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492038622",
            "telephone_number": "517-205-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N SHERMAN ST",
            "city": "LESLIE",
            "state": "MI",
            "postal_code": "492519409",
            "telephone_number": "517-205-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "LISA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704297194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "ELLIS",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Latoshia Lynn Baruti, FNP-BC
• Kathryn Marie Brown, PA-C
• Sarah A Cardenas
• Haley Clark, LAT, ATC
• Raechel Elizabeth Coombs, D.O.
• Melissa Fink

• Family Nurse Practitioner in Leslie, MI
• Providers in Leslie, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.