Organization Active NPI

Alan B Bradley MD LLC

  • Obstetrics & Gynecology Physician
  • Lima, OH
National Provider Identifier
1659543676
Registry record updated Mar 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
35042423B Issued in OH
Legal business name
ALAN B BRADLEY MD LLC
Practice address
1220 E Elm St
Suite 204
Lima, OH 45804-2850
Phone
(419) 224-2632
Fax
(419) 222-2731
NPI assigned
Mar 31, 2008
Last updated
Mar 31, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2008

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

Authorized official

Name
Dr. Alan B Bradley, MDNPI 1801878046
Title
Owner
Phone
(419) 224-2632

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 35042423B OH Primary

Addresses

Primary practice location

1220 E Elm St
Suite 204
Lima, OH 45804-2850

Mailing address

1220 E Elm St
Suite 204
Lima, OH 45804-2850
Phone (419) 224-2632

Other identifiers 1

IdentifierTypeStateIssuer
0492864MedicaidOH

National Provider Directory

National Provider Directory

Locations

1220 E Elm St
Ste 205
Lima, OH 45804
Phone (419) 224-1500

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1659543676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 E ELM ST",
            "address_2": "SUITE 204",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042850",
            "telephone_number": "419-224-2632",
            "fax_number": "419-222-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 E ELM ST",
            "address_2": "SUITE 204",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042850",
            "telephone_number": "419-224-2632",
            "fax_number": "419-222-2731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAN B BRADLEY MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-224-2632",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35042423B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0492864",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.