Individual provider Active NPI

Rhonda Bradford, NP

  • Acute Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1659701415
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
653164 Issued in TX
Practice address
12221 Merit Dr Ste 1610
Dallas, TX 75251-2204
Phone
(214) 217-1926
NPI assigned
Nov 14, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 653164 TX
Acute Care Nurse Practitioner 363LA2100X 653164 TX Primary

Addresses

Primary practice location

12221 Merit Dr Ste 1610
Dallas, TX 75251-2204

Mailing address

3001 Blue Heron Dr
Mesquite, TX 75181-4949
Phone (214) 298-3817

Other identifiers 2

IdentifierTypeStateIssuer
330181402MedicaidTX
330181401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140312000926 TX Practitioner - Nurse Practitioner 1850521956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Texas Heart Surgery Center, PLLCGroup PAC ID 6901081363, 22 clinicians

Practice addresses (Care Compare)

3901 W 15TH St
Medical City Plano
Plano, TX 75075-7738
Phone (972) 596-6800

Hospital & facility affiliations

  • Medical City Plano Hospital, Plano, TX, CCN 450651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
653164TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Texas Heart Surgery Center, PLLC CurrentSince Jan 10, 2022 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

7777 Forest Ln
Ste A307
Dallas, TX 75230
Phone (972) 566-4866

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1659701415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 BLUE HERON DR",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751814949",
            "telephone_number": "214-298-3817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 MERIT DR STE 1610",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512204",
            "telephone_number": "214-217-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "RHONDA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-14",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "653164",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "653164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330181402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330181401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.