Kelly Bradham, MT-BC

Primary specialty

Music TherapistTaxonomy code 225A00000X

License

14053

Practice address

5900 E Thomas Rd Apt G103
Scottsdale, AZ 85251-7540

Phone

(623) 205-2747

NPI assigned

Jun 3, 2021

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 3, 2021.

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1467028084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 E THOMAS RD APT G103",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 E THOMAS RD APT G103",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517540",
            "telephone_number": "623-205-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADHAM",
        "first_name": "KELLY",
        "credential": "MT-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": null,
            "license": "14053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MUSIC THERAPY BOARD CERTIFICATION (CBMT)",
            "identifier": "14053",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Scottsdale, AZ
• Music Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.