Bradley Joseph Komrowski-Poppen, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

985 Issued in AL

Practice address

2817 Reilly Road Dobh
Womack AMC
Ft Bragg, NC 28310

Phone

(910) 907-6825

Fax

(910) 907-8521

NPI assigned

Jun 26, 2006

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 names 1

• Bradley JK Poppen Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588691638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 REILLY ROAD",
            "address_2": "MCXC-COD CREDENTIALS WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "28310",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 REILLY ROAD DOBH",
            "address_2": "WOMACK AMC",
            "city": "FT BRAGG",
            "state": "NC",
            "postal_code": "28310",
            "telephone_number": "910-907-6825",
            "fax_number": "910-907-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMROWSKI-POPPEN",
        "first_name": "BRADLEY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AL",
            "license": "985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRADLEY",
            "last_name": "POPPEN",
            "middle_name": "JK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Chad A Koenig
• Peter Christopher Koepp, PA-C
• Jordann Kokoski, DO
• Revati Komandur, MD
• John Komas
• John Victor Korby, FNP
• Dawn Korcz
• Rita A Kostecke, MD, MPH
• Arpan Kothari, D.O.
• Bruce Sheldon Kottler, PH.D.

• Psychologist in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.