Active NPI
David L Bradham, D.C.
- Chiropractor
- Erwin, NC
National Provider Identifier
1447251533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2481
- Practice address
- 407-K East Jackson Blvd
Erwin, NC 28339-9628 - Phone
- (910) 892-1119
- Fax
- (910) 892-1614
- NPI assigned
- Aug 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2481 | NC | Primary |
Addresses
Primary practice location
407-K East Jackson Blvd
Erwin, NC 28339-9628
Mailing address
PO Box 506
Erwin, NC 28339-0506
Phone (910) 892-1119
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0830T | Other | NC | BLUE CROSS BLUE SHIELD |
| 8902671 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Cleveland Chiropractic College - Kansas City, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
407 K E Jackson Blvd
Erwin, NC 28339-9628
Phone (910) 892-1119
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2481 | NC | MD | Marriage & Family Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Erwin, NC
- NPI 1578658514
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447251533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 506",
"city": "ERWIN",
"state": "NC",
"postal_code": "283390506",
"telephone_number": "910-892-1119",
"fax_number": "910-892-1614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407-K EAST JACKSON BLVD",
"city": "ERWIN",
"state": "NC",
"postal_code": "283399628",
"telephone_number": "910-892-1119",
"fax_number": "910-892-1614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADHAM",
"first_name": "DAVID",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "2481",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0830T",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8902671",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Erwin, NC
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.