Individual provider Active NPI

Sierra Bradeen

  • Clinical Social Worker
  • Elko, NV
National Provider Identifier
1548797392
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1009 Silver St
Elko, NV 89801-3936
Phone
(775) 397-3486
NPI assigned
May 11, 2017
Last updated
May 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary
Rehabilitation Practitioner 225400000X

Addresses

Primary practice location

1009 Silver St
Elko, NV 89801-3936

Mailing address

720 Sterling Dr
Spring Creek, NV 89815-6211
Phone (775) 397-3486

Other practice location 1

1515 7th St
Elko, NV 89801-2859
Phone (775) 299-3738

Other identifiers 1

IdentifierTypeStateIssuer
1780936435MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221114001307 NV Practitioner - Clinical Social Worker 4486021185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1009 Silver St
Elko, NV 89801-3936
Phone (775) 753-6258

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ruby Mountain Recovery Rehabilitation Practitioner CurrentSince Sep 17, 2022 Accepting new patients
US Holdings LLC Past Accepting new patients

Locations

445 Apple St
Ste 102
Reno, NV 89502

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1548797392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 STERLING DR",
            "city": "SPRING CREEK",
            "state": "NV",
            "postal_code": "898156211",
            "telephone_number": "775-397-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 SILVER ST",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898013936",
            "telephone_number": "775-397-3486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 7th St",
            "address_purpose": "LOCATION",
            "city": "Elko",
            "state": "NV",
            "postal_code": "898012859",
            "country_code": "US",
            "telephone_number": "775-299-3738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADEEN",
        "first_name": "SIERRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780936435",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko, NV

Sources for this page

Verify at the official NPI Registry.