Active NPI
Bradford Colegate, M.D.
- Family Medicine Physician
- Cambridge, OH
National Provider Identifier
1750355947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35-043797
- Practice address
- 1505 Clark St
Cambridge, OH 43725-9232 - Phone
- (614) 284-0608
- NPI assigned
- Feb 14, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35-043797 | OH | Primary |
Addresses
Primary practice location
1505 Clark St
Cambridge, OH 43725-9232
Mailing address
PO Box 583
Cambridge, OH 43725-0583
Phone (614) 284-0608
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0472608 | Medicaid | OH |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-043797 | OH | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322784000000",
"number": "1750355947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 583",
"city": "CAMBRIDGE",
"state": "OH",
"postal_code": "437250583",
"telephone_number": "614-284-0608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 CLARK ST",
"city": "CAMBRIDGE",
"state": "OH",
"postal_code": "437259232",
"telephone_number": "614-284-0608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEGATE",
"first_name": "BRADFORD",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-14",
"last_updated": "2011-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35-043797",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0472608",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.