Individual provider Active NPI

Megan E Bradford, NP

  • Nurse Practitioner
  • Muskegon, MI
National Provider Identifier
1710695572
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704333059 Issued in MI
Practice address
990 Terrace St # 980
Muskegon, MI 49442-3395
Phone
(616) 450-6921
NPI assigned
Nov 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704333059 MI Primary

Addresses

Primary practice location

990 Terrace St # 980
Muskegon, MI 49442-3395

Mailing address

17195 80TH Ave
Coopersville, MI 49404-9461
Phone (616) 450-6921

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbradford@wellpath.us Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20230530002715 MI Practitioner - Nurse Practitioner 3577920974 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704333059MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Vein Restoration Mi PLLC CurrentSince May 22, 2023 Accepting new patients
Center for Vein Restoration Mi PLLC CurrentSince May 22, 2023 Accepting new patients

Locations

7474 Greenway Center Dr
Ste 1000
Greenbelt, MD 20770
Phone (240) 965-3271

4085 Burton St SE
Ste 101
Grand Rapids, MI 49546

837 Seminole Rd
Ste 204
Norton Shores, MI 49441

3810 W Centre Ave
Ste A
Portage, MI 49024

Interoperability endpoints

  • Direct secure messaging: megan.bradfordnp.p3@direct.cvr.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1710695572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17195 80TH AVE",
            "city": "COOPERSVILLE",
            "state": "MI",
            "postal_code": "494049461",
            "telephone_number": "616-450-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 TERRACE ST # 980",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494423395",
            "telephone_number": "616-450-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "MEGAN",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704333059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbradford@wellpath.us",
            "affiliation": "N",
            "endpointDescription": "wellpath",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "990 Terrace St # 980",
            "city": "Muskegon",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494423395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.