Individual provider Active NPI

Janet M Bradstreet, ARNP

  • Women's Health Nurse Practitioner
  • Daytona Beach, FL
National Provider Identifier
1497008643
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
ARNP 9273875 Issued in FL
Practice address
1845 Holsonback Dr
Daytona Beach, FL 32117-5114
Phone
(386) 274-0500
Fax
(386) 274-0860
NPI assigned
Oct 24, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X ARNP 9273875 FL Primary

Addresses

Primary practice location

1845 Holsonback Dr
Daytona Beach, FL 32117-5114

Mailing address

1845 Holsonback Dr
Daytona Beach, FL 32117-5114
Phone (386) 274-0500

Other identifiers 1

IdentifierTypeStateIssuer
007285900MedicaidFL

Other names 1

  • Janet M Bradstreet-Coope Former name

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 9273875FLMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1497008643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 HOLSONBACK DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175114",
            "telephone_number": "386-274-0500",
            "fax_number": "386-274-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 HOLSONBACK DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175114",
            "telephone_number": "386-274-0500",
            "fax_number": "386-274-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSTREET",
        "first_name": "JANET",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-24",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "ARNP 9273875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007285900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANET",
            "last_name": "BRADSTREET-COOPE",
            "middle_name": "M",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; 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.