Active NPI
Gustavia Bradford
- Bus
- Belcher, LA
National Provider Identifier
1669047601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Bus
- License
- 005971290
- Practice address
- 6240 Belcher Oil City Rd
Belcher, LA 71004-7100 - Phone
- (318) 426-6976
- NPI assigned
- May 21, 2021
- 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 |
|---|---|---|---|---|
| Bus | 347B00000X | 005971290 | LA | Primary |
Addresses
Primary practice location
6240 Belcher Oil City Rd
Belcher, LA 71004-7100
Mailing address
6240 Belcher Oil City Rd
Belcher, LA 71004-0134
Phone (318) 426-6976
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86-3750549 | Medicaid | LA |
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 |
|---|---|---|---|
| 005971290 | LA | MD | Bus |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1669047601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6240 BELCHER OIL CITY RD",
"city": "BELCHER",
"state": "LA",
"postal_code": "710040134",
"telephone_number": "318-426-6976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6240 BELCHER OIL CITY RD",
"city": "BELCHER",
"state": "LA",
"postal_code": "710047100",
"telephone_number": "318-426-6976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADFORD",
"first_name": "GUSTAVIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-21",
"last_updated": "2021-05-24",
"certification_date": "2021-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "347B00000X",
"taxonomy_group": "",
"desc": "Bus",
"state": "LA",
"license": "005971290",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "86-3750549",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Belcher, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.