Active NPI
Bradley Watts, RD
- Registered Dietitian
- Redding, CA
National Provider Identifier
1710569942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 3385 Wimbledon Dr
Redding, CA 96002-9516 - Phone
- (530) 227-9364
- NPI assigned
- Apr 27, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | CA | Primary |
Addresses
Primary practice location
3385 Wimbledon Dr
Redding, CA 96002-9516
Mailing address
3385 Wimbledon Dr
Redding, CA 96002-9516
Phone (530) 227-9364
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221107001725 | CA | Practitioner - Registered Dietitian Or Nutrition Professional | 1153798061 | Practice locations: Redding, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619481600000",
"number": "1710569942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3385 WIMBLEDON DR",
"city": "REDDING",
"state": "CA",
"postal_code": "960029516",
"telephone_number": "530-227-9364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3385 WIMBLEDON DR",
"city": "REDDING",
"state": "CA",
"postal_code": "960029516",
"telephone_number": "530-227-9364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "BRADLEY",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-04-27",
"last_updated": "2021-04-27",
"certification_date": "2021-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.