Active NPI
Bradyn Channing Jasper, DO
- General Acute Care Hospital
- Vineland, NJ
National Provider Identifier
1750122560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- Practice address
- 1505 W Sherman Ave
Vineland, NJ 08360-7059 - Phone
- (856) 641-8000
- NPI assigned
- Jun 5, 2024
- 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 |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | Primary |
Addresses
Primary practice location
1505 W Sherman Ave
Vineland, NJ 08360-7059
Mailing address
23 Rebecca CT
Washington, MO 63090-5507
Phone (636) 432-8066
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
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717545600000",
"number": "1750122560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 REBECCA CT",
"city": "WASHINGTON",
"state": "MO",
"postal_code": "630905507",
"telephone_number": "636-432-8066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 W SHERMAN AVE",
"city": "VINELAND",
"state": "NJ",
"postal_code": "083607059",
"telephone_number": "856-641-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JASPER",
"first_name": "BRADYN",
"middle_name": "CHANNING",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-05",
"last_updated": "2024-06-05",
"certification_date": "2024-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vineland, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.