Teresa Braddy, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN9206359 Issued in FL

Practice address

2 Shircliff Way
Suite 900
Jacksonville, FL 32204-4753

Phone

(904) 381-9651

NPI assigned

Jan 21, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1609265107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N MARTEL AVE",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900466611",
            "telephone_number": "323-436-5019",
            "fax_number": "323-337-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY",
            "address_2": "SUITE 900",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044753",
            "telephone_number": "904-381-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADDY",
        "first_name": "TERESA",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9206359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Taylor Braddock, RD, LDN
• Jessica Ann Braddock
• Kathryn Braddock, ARNP
• Matthew Todd Braddock, D.O.
• Kathryn Braddy-Dillard, APRN-CNP
• Lissi Caryn Bradfield, BCBA
• Scott M. Bradfield, MD
• Bradford Homeliving LLC
• Cynthia Ruth Bradford, MSH, RD, LD/N
• Jason Bradford

• Registered Nurse in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.

Verify at the official NPI Registry.