Individual provider Active NPI

Dejon Menqual Bradley

  • Personal Care Attendant
  • Massillon, OH
National Provider Identifier
1700751591
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
335 12TH St SW
Massillon, OH 44647-6305
Phone
(330) 632-0444
NPI assigned
Oct 9, 2025
Last updated
Oct 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X OH Primary

Addresses

Primary practice location

335 12TH St SW
Massillon, OH 44647-6305

Mailing address

335 12TH St SW
Massillon, OH 44647-6305
Phone (330) 632-0444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1759968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1700751591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 12TH ST SW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446476305",
            "telephone_number": "330-632-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 12TH ST SW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446476305",
            "telephone_number": "330-632-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "DEJON",
        "middle_name": "MENQUAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-09",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.