Bradley Alan Speta, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F305382-1 Issued in NY

Practice address

12 Martin St
Wellsville, NY 14895-1057

Phone

(585) 593-7460

Fax

(585) 593-7474

NPI assigned

Jun 8, 2010

Last updated

Dec 30, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

State licenses

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.

• Christopher R Depner, M.D.

  • Family Medicine Physician
  • Wellsville, NY
  • NPI 1104810944
  Medicare reassignment

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1689994147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MARTIN ST",
            "city": "WELLSVILLE",
            "state": "NY",
            "postal_code": "148951057",
            "telephone_number": "585-593-7460",
            "fax_number": "585-593-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 MARTIN ST",
            "city": "WELLSVILLE",
            "state": "NY",
            "postal_code": "148951057",
            "telephone_number": "585-593-7460",
            "fax_number": "585-593-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPETA",
        "first_name": "BRADLEY",
        "middle_name": "ALAN",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-08",
        "last_updated": "2011-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305382-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Tier Home Health Services Inc
• Southern Tier Home Medical Supplies, Inc.
• Southern Tier Medical PLLC
• Southern Tier Optometric Center Inc (Council Optometric Center)
• Krystle Dawn Spencer, RN
• Kathleen Speta, FNP
• Glenda Stocking
• Cathy J Strawcutter
• Jeanne M Streeter, NP
• Jennifer Studley, LMSW, CASAC-T

• Adult Health Nurse Practitioner in Wellsville, NY
• Providers in Wellsville, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; 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.