Individual provider Active NPI

Ramona Bradley, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1578088258
Registry record updated Dec 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AC002075 Issued in MD
Practice address
614 Eastern Shore Dr Ste a
Salisbury, MD 21804-5940
Phone
(410) 831-3137
Fax
(410) 831-3138
NPI assigned
Aug 3, 2017
Last updated
Dec 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X LP-0000208 DE
Gerontology Nurse Practitioner 363LG0600X AC002075 MD
Gerontology Nurse Practitioner 363LG0600X LP-0000208 DE
Adult Health Nurse Practitioner 363LA2200X AC002075 MD Primary

Addresses

Primary practice location

614 Eastern Shore Dr Ste a
Salisbury, MD 21804-5940

Mailing address

614 Eastern Shore Dr
Ste a
Salisbury, MD 21804-5940
Phone (443) 880-4755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP-0000208DEMDGerontology Nurse Practitioner
AC002075MDMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512604800000",
    "number": "1578088258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 EASTERN SHORE DR",
            "address_2": "STE A",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045940",
            "telephone_number": "443-880-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 EASTERN SHORE DR STE A",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045940",
            "telephone_number": "410-831-3137",
            "fax_number": "410-831-3138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "RAMONA",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2017-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "DE",
            "license": "LP-0000208",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "AC002075",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "DE",
            "license": "LP-0000208",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "AC002075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.