Active NPI
Kirsten Bradley, KIRSTEN BRADLEY
- Occupational Therapist
- Advance, NC
National Provider Identifier
1639493075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5461
- Practice address
- 142 Bermuda Village Dr
Attn: PT/OT Department
Advance, NC 27006-7867 - Phone
- (336) 998-6112
- NPI assigned
- Mar 14, 2010
- Last updated
- Mar 14, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5461 | NC | Primary |
Addresses
Primary practice location
142 Bermuda Village Dr
Attn: PT/OT Department
Advance, NC 27006-7867
Mailing address
3945 Lois St
Winston Salem, NC 27127-5832
Phone (336) 785-0096
Other names 1
- Kirsten Bradley
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5461 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268524800000",
"number": "1639493075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3945 LOIS ST",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271275832",
"telephone_number": "336-785-0096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142 BERMUDA VILLAGE DR",
"address_2": "ATTN: PT/OT DEPARTMENT",
"city": "ADVANCE",
"state": "NC",
"postal_code": "270067867",
"telephone_number": "336-998-6112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "KIRSTEN",
"credential": "KIRSTEN BRADLEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-14",
"last_updated": "2010-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "5461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIRSTEN",
"last_name": "BRADLEY",
"credential": "OTR/L",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Advance, NC
- Bermuda Village Retirement Center Limited Partnership (Bermuda Village)
- Bermuda Village Retirement Center Limited Partnership (Bermuda Village Retirement Center)
- Kristen Powell Blakley, P.T.
- Celine Bongaerts, LPC
- Margaret McRae Bovender, NP
- Charles Leon Branch Jr., MD
- Brandon Rehabilitation, LLC
- Bryan Eugene Brandon, P.T.
- Thomas S. Browder, D.D.S.
- Brunt Home Health LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.