Bradley Scott

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

BRADLEY SCOTT

Practice address

1400 E 12 Mile Rd
Madison HTS, MI 48071-2651

Phone

(248) 658-1116

Fax

(248) 658-1120

NPI assigned

Jun 20, 2012

Last updated

Jun 20, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bradley R Scott, M.A.

Title

Intern

Phone

(248) 658-1116

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340150400000",
    "number": "1689937153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E 12 MILE RD",
            "city": "MADISON HTS",
            "state": "MI",
            "postal_code": "480712651",
            "telephone_number": "248-658-1116",
            "fax_number": "248-658-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E 12 MILE RD",
            "city": "MADISON HTS",
            "state": "MI",
            "postal_code": "480712651",
            "telephone_number": "248-658-1116",
            "fax_number": "248-658-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY SCOTT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-06-20",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "INTERN",
        "authorized_official_telephone_number": "248-658-1116",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.