Bradford Marshall Smith, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

54963 Issued in MS

Practice address

110 Hale St
Beverly, MA 01915-4634

Phone

(781) 710-8300

NPI assigned

Mar 14, 2006

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

Opted out of Medicare

Yes, effective Dec 13, 2024 through Dec 13, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1477522555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HALE ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019154634",
            "telephone_number": "781-710-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HALE ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019154634",
            "telephone_number": "781-710-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRADFORD",
        "middle_name": "MARSHALL",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MS",
            "license": "54963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Frederick Smail Jr., MD
• Abigail Smith
• Alyssa Nicole Smith
• Barbara Lynn Smith, DVM, MS, PHD
• Blair E Smith, MSW, LICSW
• Hillary Smith, LCSW
• Matthew Smith, DPT
• Nicole Ann Smith, RN, MS, WHNP-BC
• Sheri Smith
• Sheridan Smith, BCBA

• Psychologist in Beverly, MA
• Providers in Beverly, MA by specialty
• Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.