Audrey Elise Bradford

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10005240A Issued in IN

Practice address

1660 Broadway Ste 165
Fort Wayne, IN 46802-0011

Phone

(260) 266-9805

Fax

(260) 266-9815

NPI assigned

Feb 10, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Parkview Health System Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952
  Medicare reassignment

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

{
    "created_epoch": "1770681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1578415089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 BROADWAY STE 165",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468020011",
            "telephone_number": "260-266-9805",
            "fax_number": "260-266-9815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "AUDREY",
        "middle_name": "ELISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-10",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601013822",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10005240A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Bracht, MBA, LAT, ATC
• Ruth Bracht, LCSW
• James M Brackmann, MD
• Brad Pulfer D.D.S., P.C.
• Bradford H Korn DDS, Inc.
• Kyle Bradford, RBT
• Devin Bradley, DPT
• Morgan Bradley
• V Jean Bradley, NP
• Holly Bradtmueller, MS CCC-SLP

• Physician Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.