NPIMap

Individual provider Active NPI

Joshua Bradford, DO

  • Family Medicine Physician
  • South Charleston, WV
National Provider Identifier
1689899510
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2241 Issued in WV
Practice address
707 Chestnut St
South Charleston, WV 25309-2003
Phone
(304) 768-8500
Fax
(304) 768-8530
NPI assigned
Apr 16, 2007
Last updated
Nov 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2241 WV Primary

Addresses

Primary practice location

707 Chestnut St
South Charleston, WV 25309-2003

Mailing address

707 Chestnut St
South Charleston, WV 25309-2003
Phone (304) 768-8500

Other identifiers 1

IdentifierTypeStateIssuer
3810016359MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090706000171 WV Practitioner - Family Practice 0547311466 Reassigns benefits to 1 organization
Practice locations: Saint Albans, WV

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spring Hill Primary Care Physicians PLLCGroup PAC ID 7810932951, 5 clinicians

Practice addresses (Care Compare)

707 Chestnut St
South Charleston, WV 25309-2003
Phone (304) 768-8500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2241WVMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Hill Primary Care Physicians PLLC Family Medicine CurrentSince Nov 17, 2012 Accepting new patients
Glasgow Hills of Journey, LLC Past Accepting new patients
Joshua Bradford Family Medicine PastSince Jan 1, 2016 Accepting new patients
Glasgow Health and Rehabilitation Past Accepting new patients
Riverside Valley of Journey, LLC Past Accepting new patients
Riverside Health and Rehabilitation, LLC Past Accepting new patients

Locations

707 Chestnut St
South Charleston, WV 25309
Phone (304) 768-8500

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Riverside Valley of JourneySaint Albans, WV, CCN 515035 Skilled nursing facility Corporate Officer
Operational/Managerial Control
Adp of the SNF		 Sep 1, 2024
Sep 1, 2024
Sep 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1689899510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CHESTNUT ST",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253092003",
            "telephone_number": "304-768-8500",
            "fax_number": "304-768-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 CHESTNUT ST",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253092003",
            "telephone_number": "304-768-8500",
            "fax_number": "304-768-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "JOSHUA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "2241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810016359",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.