Carolyn R Braddock, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

330028 Issued in NY

Practice address

777 Clinton Ave S
Rochester, NY 14620-1401

Phone

(585) 279-4800

Fax

(585) 442-8319

NPI assigned

Jul 11, 2006

Last updated

Jul 23, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Highland Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1972548568
  Medicare reassignment NPD
• Highland Hospital of Rochester

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1740220698
  NPD
• Highland Hospital of Rochester

  dba Highland Hospital Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Rochester, NY
  • NPI 1962725739
  NPD
• Strong Obstetrics-Gynecology Group

  • Obstetrics & Gynecology Physician
  • Rochester, NY
  • NPI 1184668311
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1669406864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 CLINTON AVE S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146201401",
            "telephone_number": "585-279-4800",
            "fax_number": "585-442-8319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CLINTON AVE S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146201401",
            "telephone_number": "585-279-4800",
            "fax_number": "585-442-8319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADDOCK",
        "first_name": "CAROLYN",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "330028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "NP0405",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P019330028",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Braces of Greece
• Adam Bracken, MD
• Brittany Bracken, RN
• Christie Sue Bracken
• Susan L Bracker, DDS
• Dana Bradford
• Lacey Bradford
• Rochelle Bradford
• Shadel Bradford, LPN
• Zahira Bradford, LPN

• Nurse Practitioner in Rochester, NY
• Providers in Rochester, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.