Robert Claud Bradley, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19366 Issued in CO

Practice address

1455 Main St
Suite 100
Windsor, CO 80550-5559

Phone

(970) 686-3950

Fax

(970) 686-3960

NPI assigned

Jan 23, 2007

Last updated

Jan 19, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18545/brand/1/csg/1/fhir/r4
• Direct secure messaging: robert.bradley.1@18545.direct.athenahealth.com

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.

• St Lukes Medical Clinic LLC

  • Internal Medicine Physician
  • Fort Collins, CO
  • NPI 1407953581
  Medicare reassignment NPD

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421625600000",
    "number": "1508910894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 MAIN ST",
            "address_2": "SUITE 200",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805505559",
            "telephone_number": "970-686-3950",
            "fax_number": "970-686-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 MAIN ST",
            "address_2": "SUITE 100",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805505559",
            "telephone_number": "970-686-3950",
            "fax_number": "970-686-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "ROBERT",
        "middle_name": "CLAUD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2015-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "19366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER PTAN",
            "identifier": "P00944651",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1193663",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johnna C Bontadelli, O.D.
• Mary Koelling Borneman, M.ED, CCC-SLP
• Myiah Bornhoft, PHARMD
• Jeffry Bott, R.M.T.
• Stephanie Boyce, DPT
• Wade Preston Brandon, LPC
• Luke Brandt, NRP
• Jessica Brasselero, MT.0019686
• Jahna Brazier, RMT
• Laurie Brethauer

• Family Medicine Physician in Windsor, CO
• Providers in Windsor, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.