Reatha Jeannette Bradberry I, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

561891 Issued in TX

Practice address

3838 W Park Ave
Orange, TX 77630-1812

Phone

(409) 886-8700

Fax

(409) 886-5305

NPI assigned

May 5, 2006

Last updated

Dec 31, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 TX

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

Specialty

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jasper County Urgent Care PLLCGroup PAC ID 8820365695, 3 clinicians

Hooked on Health Family Practice PLLCGroup PAC ID 4587999818, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Jasper Memorial Hospital Hospital, Jasper, TX, CCN 450573

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23344/brand/1/csg/1/fhir/r4

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.

• Hooked on Health Family Practice PLLC

  dba Hooked on Health Family Practice

  • Family Medicine Physician
  • Jasper, TX
  • NPI 1295200228
  Medicare reassignment Care Compare group NPD
• Jasper County Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Jasper, TX
  • NPI 1972038503
  Medicare reassignment Care Compare group NPD
• Port Arthur Emergency Physicians

  • Emergency Medicine Physician
  • Port Arthur, TX
  • NPI 1255491627

  Nurse Practitioner

  Medicare reassignment NPD
• Wesley Palmer DO PA

  dba Family Clinic

  • Family Medicine Physician
  • Bridge City, TX
  • NPI 1295804573
  NPD (past)

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

• Christus Health Southeast Texas

  dba CHRISTUS Southeast Texas - Jasper Memorial

  • Rural Acute Care Hospital
  • Jasper, TX
  • NPI 1598749707
  Care Compare affiliation

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230681600000",
    "number": "1548219876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 W PARK AVE",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776301812",
            "telephone_number": "409-886-8700",
            "fax_number": "409-886-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 W PARK AVE",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776301812",
            "telephone_number": "409-886-8700",
            "fax_number": "409-886-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBERRY",
        "first_name": "REATHA",
        "middle_name": "JEANNETTE",
        "name_prefix": "Mrs.",
        "name_suffix": "I",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "561891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "760357897",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161031301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Biotronics Kidney Center of Beaumont, Inc (Biotronics Kidney Center of Orange, Inc)
• Josh Bland, HIS
• Nicole Block
• Allisha Gayle Skinner Bonneaux, MED,LPC
• Malinda Charisse Boudreaux, LPC
• Tara Breaux, NP-C
• Brewer Dental PLLC
• Bright Branch ABA, LLC
• Bright Futures Pediatric Therapy
• Marilee Katherine Brinson, M.S., CCC-SLP

• Nurse Practitioner in Orange, TX
• Providers in Orange, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.