Individual provider Active NPI

Lori Bradley, APRN

  • Nurse Practitioner
  • Hazard, KY
National Provider Identifier
1447537105
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3007224 Issued in KY
Practice address
200 Medical Center Dr
Suite 2M
Hazard, KY 41701-9466
Phone
(606) 487-1818
Fax
(606) 487-8448
NPI assigned
Nov 9, 2011
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3007224 KY Primary

Addresses

Primary practice location

200 Medical Center Dr
Suite 2M
Hazard, KY 41701-9466

Mailing address

200 Medical Center Dr
Suite 2M
Hazard, KY 41701-9466
Phone (606) 487-1818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20120221000700 KY Practitioner - Nurse Practitioner 6103084223 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3007224KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brock Medical, LLC Nurse Practitioner CurrentSince Mar 18, 2022 Accepting new patients
Fast Pace Kentucky PLLC CurrentSince Sep 24, 2023 Accepting new patients
Mountain After Hours Clinic PSC CurrentSince May 17, 2017 Accepting new patients
Fast Pace Kentucky PLLC CurrentSince Mar 18, 2022 Accepting new patients
Fast Pace Kentucky, PLLC CurrentSince Sep 24, 2023 Accepting new patients
Jackson Physician Corp Past Accepting new patients
Fast Pace Kentucky, PLLC Past Accepting new patients

Locations

110 S 2nd St
Central City, KY 42330
Phone (270) 931-2059

1873 Cumberland Falls Hwy
Corbin, KY 40701
Phone (606) 404-6450

1475 Nashville Rd
Franklin, KY 42134
Phone (270) 813-1111

1908 N Main St
Ste 120
Hazard, KY 41701
Phone 60643926622038

1649 Highway 192 W
London, KY 40741
Phone (606) 330-0055

480 Bullion Blvd
#B
Winchester, KY 40391
Phone (859) 385-4222

Interoperability endpoints

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

Organizations & group practices 7

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": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1447537105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEDICAL CENTER DR",
            "address_2": "SUITE 2M",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019466",
            "telephone_number": "606-487-1818",
            "fax_number": "606-487-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL CENTER DR",
            "address_2": "SUITE 2M",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019466",
            "telephone_number": "606-487-1818",
            "fax_number": "606-487-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "LORI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-09",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3007224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

Verify at the official NPI Registry.