Individual provider Active NPI

Nicole Marie Bradley, DVM

  • Veterinarian
  • Roseville, CA
National Provider Identifier
1598062895
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
16830 Issued in CA
Practice address
9260 Sierra College Blvd
Roseville, CA 95661-5927
Phone
(916) 774-6630
NPI assigned
Feb 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 16830 CA Primary

Addresses

Primary practice location

9260 Sierra College Blvd
Roseville, CA 95661-5927

Mailing address

9260 Sierra College Blvd
Roseville, CA 95661-5927

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16830CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298332800000",
    "number": "1598062895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9260 SIERRA COLLEGE BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956615927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9260 SIERRA COLLEGE BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956615927",
            "telephone_number": "916-774-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "DVM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-22",
        "last_updated": "2011-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "CA",
            "license": "16830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2011; 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.