Jim Bradway MD PC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

1654201205 Issued in UT

Legal business name

JIM BRADWAY MD PC

Practice address

630 Medical Dr
Bountiful, UT 84010-4908

Phone

(801) 292-6231

NPI assigned

Feb 1, 2011

Last updated

Feb 1, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jim Bradway, MD

Title

Owner

Phone

(801) 364-2278

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Layne B Croxford, CRNA

  • Certified Registered Nurse Anesthetist
  • Ogden, UT
  • NPI 1225048937
  NPD (past)
• Douglas C Bankhead, MD

  • Anesthesiology Physician
  • Columbia, MO
  • NPI 1700896347
  NPD (past)

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

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296518400000",
    "number": "1639475171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E SOUTH TEMPLE",
            "address_2": "619",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841111250",
            "telephone_number": "801-364-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 MEDICAL DR",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104908",
            "telephone_number": "801-292-6231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIM BRADWAY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-01",
        "last_updated": "2011-02-01",
        "status": "A",
        "authorized_official_last_name": "BRADWAY",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-364-2278",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "1654201205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tayler Jensen, CCC-SLP
• Tenille Jensen
• Vera Anna Jensen
• Sara Nicole Jeppson
• Meiqi Jiang
• Joe R Nielsen MD PC
• Veronica Maria Jofre
• John B Lyman MD PC
• John C. Edwards MD Inc.
• Colin Johns-Hegerhorst

• Anesthesiology Physician in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Anesthesiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.