Jeffrey Logan Bradley, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

50.010299RX Issued in OH

Practice address

903 Doris Jane Ave
Fairfield, OH 45014-2716

Phone

(513) 462-6471

NPI assigned

Apr 9, 2025

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1487449609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 DORIS JANE AVE",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142716",
            "telephone_number": "513-462-6471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 DORIS JANE AVE",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142716",
            "telephone_number": "513-462-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "JEFFREY",
        "middle_name": "LOGAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-09",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.010299RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin James Bowers, PHARMD
• Haley Bowra, LSW
• De'Asiah Nateerah Boyd
• Samantha Boyd
• Diane Bradley
• Scot M Brainard, LPN
• Sydney Braine
• Regina Brako Agyei
• Charles Shimon Brand, PHD., LISW
• Kimberly Lynn Brant, LLPC

• Surgical Physician Assistant in Fairfield, OH
• Providers in Fairfield, OH by specialty
• Surgical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; 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.