Individual provider Active NPI

Donna Koss Bradish, CRNP

  • Family Nurse Practitioner
  • The Villages, FL
National Provider Identifier
1487050522
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9414717 Issued in FL
Practice address
2485 Pinellas PL
The Villages, FL 32163
Phone
(352) 674-1720
Fax
(352) 674-8920
NPI assigned
Nov 18, 2014
Last updated
Dec 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP014497 PA
Family Nurse Practitioner 363LF0000X APRN9414717 FL Primary

Addresses

Primary practice location

2485 Pinellas PL
The Villages, FL 32163

Mailing address

1020 Lake Sumter LNDG
The Villages, FL 32162-2699
Phone (352) 674-8805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20151201001817 FL Practitioner - Nurse Practitioner 2567786304 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Villages Health System LLCGroup PAC ID 2163667288, 146 clinicians

Practice addresses (Care Compare)

2485 Pinellas PL
The Villages, FL 32163-2703
Phone (352) 674-1720

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9414717FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care Vitality Inc CurrentSince Nov 7, 2025 Accepting new patients
Centerwell Senior Primary Care Vitality Inc CurrentSince Nov 7, 2025 Accepting new patients
The Villages Health System LLC CurrentSince Jan 7, 2019 Accepting new patients
Centerwell Senior Primary Care Vitality Inc Past Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

1020 Lake Sumter Lndg
The Villages, FL 32162

2485 Pinellas Pl
The Villages, FL 32163
Phone (352) 674-1720

280 Farner Pl
The Villages, FL 32163
Phone (352) 674-1710

1400 N US Highway 441
Ste 930
The Villages, FL 32159
Phone (352) 750-2108

2910 Brownwood Blvd
The Villages, FL 32163
Phone (352) 674-1790

Interoperability endpoints

  • Direct secure messaging: donna.koss-bradish.1@18324.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/18324/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1487050522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 LAKE SUMTER LNDG",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321622699",
            "telephone_number": "352-674-8805",
            "fax_number": "352-674-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 PINELLAS PL",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "32163",
            "telephone_number": "352-674-1720",
            "fax_number": "352-674-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSS BRADISH",
        "first_name": "DONNA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-18",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP014497",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9414717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.