Individual provider Active NPI

Kristen Michelle Bradford, FNP

  • Family Nurse Practitioner
  • Thomaston, GA
National Provider Identifier
1508391889
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN214849 Issued in GA
Practice address
1512 Highway 19 N
Thomaston, GA 30286-2258
Phone
(706) 647-2641
Fax
(706) 647-2680
NPI assigned
Apr 25, 2017
Last updated
Apr 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN214849 GA Primary

Addresses

Primary practice location

1512 Highway 19 N
Thomaston, GA 30286-2258

Mailing address

1512 Highway 19 N
Thomaston, GA 30286-2258
Phone (706) 647-2641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20170518001444 GA Practitioner - Nurse Practitioner 2264709484 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Upson Family Medical Center, LLCGroup PAC ID 9032472824, 6 clinicians
Upson County Hospital IncGroup PAC ID 8729075536, shared by 3 NPIs, 11 clinicians

Practice addresses (Care Compare)

1512 Hwy 19 N
Thomaston, GA 30286-2258
Phone (706) 647-2641

206 Cherokee Rd
Thomaston, GA 30286-3402
Phone (706) 647-8111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upson Family Medical Center ,LLC CurrentSince Mar 31, 2025 Accepting new patients
Truffles Vein Center, LLC CurrentSince Feb 1, 2022 Accepting new patients
Truffles Vein of Central Georgia LLC PastSince Feb 1, 2022 Accepting new patients

Locations

874 Lanier Ave W
Ste 220
Fayetteville, GA 30214
Phone (678) 833-1444

96 Vinings Dr
McDonough, GA 30253
Phone (678) 833-1444

8 E Court Sq
Newnan, GA 30263
Phone (678) 833-1444

1512 Highway 19 N
Thomaston, GA 30286
Phone (706) 647-2641

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1508391889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 HIGHWAY 19 N",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302862258",
            "telephone_number": "706-647-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 HIGHWAY 19 N",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302862258",
            "telephone_number": "706-647-2641",
            "fax_number": "706-647-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "KRISTEN",
        "middle_name": "MICHELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN214849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomaston, GA

Sources for this page

Verify at the official NPI Registry.