Kierstin Elizabeth Bradley
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Rapid City, SD
NPI 1649023938 · NPPES record last updated Apr 8, 2024
Key facts
- NPI
- 1649023938
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 502 E Monroe St
Rapid City, SD 57701-1400 - Phone
- (605) 755-4060
- Fax
- (605) 755-4012
- NPI assigned
- Apr 8, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240801003323 | SD | Order and Referring Only - Family Practice |
3173060688 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
502 E Monroe St
Rapid City, SD 57701-1400
Mailing address
502 E Monroe St
Rapid City, SD 57701-1400
Phone (605) 755-4060
Other providers in Rapid City, SD
- Diana Boyle
- Kathleen A Boyle
- Brad Moriarty OD PC
- Brent J. Bradley
- Heather R Bradley
- Mikayla Bradley
- Shari Lynn Bradstream
- Danielle Rose Brady
- Brain Health Salon LLC
- Sharron K Bramblee
All providers in Rapid City, SD · Student in an Organized Health Care Education/Training Program in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.