Sheila Diane Bradford, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R548669 Issued in MS

Practice address

3115 Audubon Dr
Laurel, MS 39440-1913

Phone

(601) 531-2200

Fax

(061) 531-2220

NPI assigned

Nov 30, 2006

Last updated

Feb 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22845/brand/1/csg/1/fhir/r4

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.

• North Laurel Family Medicine, LLC

  • Nurse Practitioner
  • Laurel, MS
  • NPI 1265921985
  Medicare reassignment NPD
• South Central Clinics, Inc

  dba Ellisville Medical Clinic

  • Family Medicine Physician
  • Ellisville, MS
  • NPI 1801226287
  Medicare reassignment NPD
• South Central Clinics, Inc

  dba South Central Urgent Care

  • Rural Health Clinic/Center
  • Laurel, MS
  • NPI 1033903547
  NPD

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1700954765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 AUDUBON DR",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401913",
            "telephone_number": "601-531-2200",
            "fax_number": "601-531-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 AUDUBON DR",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401913",
            "telephone_number": "601-531-2200",
            "fax_number": "061-531-2220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 N FRONT STREET",
            "address_purpose": "LOCATION",
            "city": "SANDERSVILLE",
            "state": "MS",
            "postal_code": "394770001",
            "country_code": "US",
            "telephone_number": "601-490-7190",
            "fax_number": "601-490-7191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1203 Avenue B",
            "address_purpose": "LOCATION",
            "city": "Ellisville",
            "state": "MS",
            "postal_code": "39437",
            "country_code": "US",
            "telephone_number": "601-477-8553",
            "fax_number": "601-477-9158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "SHEILA",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R548669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "diane@northlaurelfamilymed.com",
            "affiliation": "N",
            "endpointDescription": "Provider Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Provider Email",
            "address_1": "3115 Audubon Dr",
            "city": "Laurel",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394401913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Barbara A. Boyd, P233404
• Marsha Diane Boyd, OT
• Jeanine Boykin, LMFT
• Brad Holifield, D.M.D., P.a.
• Jessica Rose Braddock, MS CCC-SLP
• Judith Lynn Bradley, M.D.
• Maylen Musgrove Brady, PA-C
• Branch of Love
• Howard K Brashiner, RN
• Adonnis Breland

• Family Nurse Practitioner in Laurel, MS
• Providers in Laurel, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.