Bradley Chiropractic Clinic PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1229 Issued in NC

Legal business name

BRADLEY CHIROPRACTIC CLINIC PA

Practice address

1324 E Garrison Blvd
Gastonia, NC 28054

Phone

(704) 861-1886

Fax

(704) 861-1578

NPI assigned

Aug 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Terry L Bradley, DCNPI 1275603599

Title

President of Corporation

Phone

(704) 861-1886

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• The Bradley Chiropractic Clinic Former legal business name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Terry Lee Bradley, DC

  • Chiropractor
  • Gastonia, NC
  • NPI 1275603599
  Medicare reassignment Care Compare group NPD Authorized official
• Katherine B Royston, DC

  • Chiropractor
  • Gastonia, NC
  • NPI 1104996412
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1508878240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "28054",
            "telephone_number": "704-861-1886",
            "fax_number": "704-861-1578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "28054",
            "telephone_number": "704-861-1886",
            "fax_number": "704-861-1578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY CHIROPRACTIC CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "704-861-1886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1229",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1961",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7908278",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Bradley Chiropractic Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Timothy Allen Boyd, PA-C
• Tonya Boyd
• Robert Wiley Brabham II, PTA
• Hannah Hicks Braddock, LAT, ATC
• Laquana Bradford
• Melissa Luelle Bradley, LCAS-A
• Terry Lee Bradley, DC
• Allison Bradshaw, LCMHC-A
• Rachel Braithwaite
• Branmarc, Inc. Family Services

• Chiropractor in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.