Nicholas Bradlee DPM PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

NB000558 Issued in MI

Legal business name

NICHOLAS BRADLEE DPM PC

Practice address

1909 Livernois
Troy, MI 48083

Phone

(248) 244-9565

Fax

(248) 244-8183

NPI assigned

Aug 20, 2006

Last updated

Nov 20, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicholas Bradlee, DPM

Title

Owner

Phone

(248) 244-9565

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1497860464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1029",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991029",
            "telephone_number": "248-244-9565",
            "fax_number": "248-244-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 LIVERNOIS",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48083",
            "telephone_number": "248-244-9565",
            "fax_number": "248-244-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS BRADLEE DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "BRADLEE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-244-9565",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "NB000558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Troy, MI
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• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.