Individual provider Active NPI

Judith Brady, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1457979510
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F308744-1 Issued in NY
Practice address
1430 Watercove LN
Lawrenceville, GA 30043-6223
Phone
(917) 701-2722
NPI assigned
Jul 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN293436 GA
Adult Health Nurse Practitioner 363LA2200X F308744-1 NY Primary

Addresses

Primary practice location

1430 Watercove LN
Lawrenceville, GA 30043-6223

Mailing address

1430 Watercove LN
Lawrenceville, GA 30043-6223
Phone (917) 701-2722

Other practice location 1

3240 Paulding Ave
Bronx, NY 10469-3843
Phone (917) 701-2722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
F308744-1NYMDAdult Health Nurse Practitioner
RN293436GAMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1457979510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 WATERCOVE LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436223",
            "telephone_number": "917-701-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 WATERCOVE LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436223",
            "telephone_number": "917-701-2722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3240 Paulding Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104693843",
            "country_code": "US",
            "telephone_number": "917-701-2722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADY",
        "first_name": "JUDITH",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN293436",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F308744-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.