Thomas Martin Bradley, HIS

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

AS3361 Issued in FL

Practice address

909 Colonial Dr
St Augustine, FL 32086-7966

Phone

(904) 377-6115

NPI assigned

May 29, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1669030284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 COLONIAL DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320867966",
            "telephone_number": "904-377-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 COLONIAL DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320867966",
            "telephone_number": "904-377-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "THOMAS",
        "middle_name": "MARTIN",
        "credential": "HIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hearing Instrument Specialist",
            "state": "FL",
            "license": "AS3361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dareon Bradwell
• Kaylan Brady, M.D.
• Michael Keith Brady, PHARM.D.
• Traci L Bragg, M.D.
• Kristina Marie Brandon, DPT

• Hearing Instrument Specialist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Hearing Instrument Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.