Individual provider Active NPI

G Bradford House, DC

  • Chiropractor
  • Union City, TN
National Provider Identifier
1740359652
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC423 Issued in TN
Practice address
208 W Main St
Union City, TN 38261-3225
Phone
(731) 885-1144
Fax
(731) 885-1157
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC423 TN Primary

Addresses

Primary practice location

208 W Main St
Union City, TN 38261-3225

Mailing address

208 W Main St
Union City, TN 38261-3225
Phone (731) 885-1144

Other identifiers 1

IdentifierTypeStateIssuer
0043951OtherTNBLUE CROSS TN PROVIDER ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120207000805 TN Practitioner - Chiropractic 1355508003 Practice locations: Union City, TN

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

208 W Main St
Union City, TN 38261-3225
Phone (731) 885-1144

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1740359652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 W MAIN ST",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382613225",
            "telephone_number": "731-885-1144",
            "fax_number": "731-885-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W MAIN ST",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382613225",
            "telephone_number": "731-885-1144",
            "fax_number": "731-885-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSE",
        "first_name": "G",
        "middle_name": "BRADFORD",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS TN PROVIDER ID",
            "identifier": "0043951",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.