Shannon Bradley, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

666347 Issued in TX

Practice address

1601 E Lamar Blvd Ste 209
Arlington, TX 76011-4464

Phone

(817) 766-6030

Fax

(817) 766-5942

NPI assigned

May 8, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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 and National Provider Directory roles.

• SBC Ventures LLC

  • Prosthetic/Orthotic Supplier
  • Arlington, TX
  • NPI 1538859194
  NPD Authorized official

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1679263305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E LAMAR BLVD STE 209",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760114464",
            "telephone_number": "817-766-6030",
            "fax_number": "817-766-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E LAMAR BLVD STE 209",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760114464",
            "telephone_number": "817-766-6030",
            "fax_number": "817-766-5942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "SHANNON",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "TX",
            "license": "666347",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "TX",
            "license": "666347",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "666347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherry L Brackens, LMSW
• Waldo P Bracy Jr., M.D.
• James Samuel Bradley, D.D.S.
• Miessa Ann Bradley
• Nakia Bradley
• Cali Bradsher
• Brady Medical Group PLLC
• James Brady, M.S.
• Leslie Brady
• Kathleen C Bragg, R.PH.

• Registered Nurse in Arlington, TX
• Providers in Arlington, TX by specialty
• Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.