Bradford John Eaton, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

20041020A Issued in IN

Practice address

314 W Catalpa Dr
Suite E
Mishawaka, IN 46545-3194

Phone

(574) 254-1700

NPI assigned

Aug 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Bradford J Eaton PHD

  • Clinical Neuropsychologist
  • Granger, IN
  • NPI 1417251109
  NPD (past) Authorized official
• Psychology Associates, P.C.

  • Clinical Neuropsychologist
  • Mishawaka, IN
  • NPI 1639285232
  NPD (past)
• Pokagon Band of Potawatomi Indians

  dba Pokagon Health Service

  • Federally Qualified Health Center (FQHC)
  • Dowagiac, MI
  • NPI 1497833271
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427068030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15744 SUNRISE TRL",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465309034",
            "telephone_number": "574-277-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 W CATALPA DR",
            "address_2": "SUITE E",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453194",
            "telephone_number": "574-254-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "BRADFORD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IN",
            "license": "20041020A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cerenna Starlie Eakright
• Connie Earnhart
• Zechariah Gage Eastland
• Jessica Easton
• Marin Emily Easton, RDN
• Brian D Eberhart, DDS
• Christopher John Eberle, DPM
• Karleisha Echols, RBT
• Stephen Conlon Eder, M.D.
• Ryan Edgar

• Clinical Neuropsychologist in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Clinical Neuropsychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.