Active NPI
Bradley M Vernallis, DC
- Orthopedic Chiropractor
- Avon Lake, OH
National Provider Identifier
1598872202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Chiropractor
- License
- 3749
- Practice address
- 33398 Walker Rd D
Avon Lake, OH 44012-1496 - Phone
- (440) 653-5220
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Chiropractor | 111NX0800X | 3749 | OH | Primary |
Addresses
Primary practice location
33398 Walker Rd D
Avon Lake, OH 44012-1496
Mailing address
120 Vineyard Rd
Avon Lake, OH 44012-1726
Phone (440) 409-0909
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3749 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438041600000",
"number": "1598872202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 VINEYARD RD",
"city": "AVON LAKE",
"state": "OH",
"postal_code": "440121726",
"telephone_number": "440-409-0909",
"fax_number": "440-409-0910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33398 WALKER RD D",
"city": "AVON LAKE",
"state": "OH",
"postal_code": "440121496",
"telephone_number": "440-653-5220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERNALLIS",
"first_name": "BRADLEY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2015-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "111NX0800X",
"taxonomy_group": "",
"desc": "Chiropractor, Orthopedic",
"state": "OH",
"license": "3749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon Lake, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.