Individual provider Active NPI

Bradford Albert Dungan, RN

  • Registered Nurse
  • Media, PA
National Provider Identifier
1609328020
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN521611L Issued in PA
Practice address
15 Levis Ave
Media, PA 19063-4826
Phone
(610) 348-2256
NPI assigned
Nov 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN521611L PA Primary
Critical Care Medicine Registered Nurse 163WC0200X RN521611L PA
Flight Registered Nurse 163WF0300X RN521611L PA

Addresses

Primary practice location

15 Levis Ave
Media, PA 19063-4826

Mailing address

15 Levis Ave
Media, PA 19063-4826

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN521611LPAMDFlight Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1609328020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LEVIS AVE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190634826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 LEVIS AVE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190634826",
            "telephone_number": "610-348-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNGAN",
        "first_name": "BRADFORD",
        "middle_name": "ALBERT",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN521611L",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "PA",
            "license": "RN521611L",
            "primary": false
        },
        {
            "code": "163WF0300X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Flight",
            "state": "PA",
            "license": "RN521611L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.