NPIMap

Organization Active NPI

David B Bradley Optometrist PC

  • Optometrist
  • Garden City, GA
National Provider Identifier
1750342192
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT000730 Issued in GA
Legal business name
DAVID B BRADLEY OPTOMETRIST PC
Practice address
22 Harrell Dr
Garden City, GA 31408-2005
Phone
(912) 964-0483
Fax
(912) 964-0488
NPI assigned
Mar 28, 2006
Last updated
Jan 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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

Authorized official

Name
Dr. David Bradley, OPTOMETRISTNPI 1902081177
Title
Owner
Phone
(912) 964-0483

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT000730 GA Primary

Addresses

Primary practice location

22 Harrell Dr
Garden City, GA 31408-2005

Mailing address

22 Harrell Dr
Garden City, GA 31408-2005
Phone (912) 964-0483

National Provider Directory

National Provider Directory

Locations

22 Harrell Dr
Garden City, GA 31408
Phone (912) 964-0483

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201219200000",
    "number": "1750342192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 HARRELL DR",
            "city": "GARDEN CITY",
            "state": "GA",
            "postal_code": "314082005",
            "telephone_number": "912-964-0483",
            "fax_number": "912-964-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 HARRELL DR",
            "city": "GARDEN CITY",
            "state": "GA",
            "postal_code": "314082005",
            "telephone_number": "912-964-0483",
            "fax_number": "912-964-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID B BRADLEY OPTOMETRIST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2008-01-25",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-964-0483",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OPTOMETRIST"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.