Individual provider Active NPI

Dan Bradbury, RN

  • Registered Nurse
  • Somerville, MA
National Provider Identifier
1497030738
Registry record updated Sep 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
99428 Issued in CO
Practice address
230 Highland Ave
Somerville, MA 02143-1408
Phone
(617) 591-4350
NPI assigned
Oct 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2013

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2286093 MA
Registered Nurse 163W00000X 99428 CO Primary
Registered Nurse 163W00000X 821827 CA
Registered Nurse 163W00000X 665382-1 NY
Registered Nurse 163W00000X RN60344652 WA

Addresses

Primary practice location

230 Highland Ave
Somerville, MA 02143-1408

Mailing address

230 Highland Ave
Somerville, MA 02143-1408
Phone (617) 591-4350

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
821827CAMDRegistered Nurse
99428COMDRegistered Nurse
RN2286093MAMDRegistered Nurse
665382-1NYMDRegistered Nurse
RN60344652WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380153600000",
    "number": "1497030738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 HIGHLAND AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021431408",
            "telephone_number": "617-591-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 HIGHLAND AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021431408",
            "telephone_number": "617-591-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBURY",
        "first_name": "DAN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-19",
        "last_updated": "2013-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2286093",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "99428",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "821827",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "665382-1",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60344652",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.