Kimberly Ross Foncham Bradley, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP 9187855 Issued in FL

Practice address

2940 S US Highway 1
Ste C11
Fort Pierce, FL 34982-8143

Phone

(772) 466-6855

Fax

(772) 464-4963

NPI assigned

Feb 21, 2015

Last updated

Feb 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medfast Urgent Care Centers LLCGroup PAC ID 1052418837, 73 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: kimberly.foncham.bradley.1@30520.direct.athenahealth.com

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

• Medfast Urgent Care Centers LLC

  • Urgent Care Clinic/Center
  • Melbourne, FL
  • NPI 1285735605
  Medicare reassignment Care Compare group
• First Choice Healthcare and Counseling, LLC

  • Medical Specialty Clinic/Center
  • Fort Pierce, FL
  • NPI 1427432715
  Medicare reassignment NPD
• Inpatient Consultants of Florida, Inc

  • Internal Medicine Physician
  • Orange Park, FL
  • NPI 1396795597
  Medicare reassignment NPD
• Inpatient Consultants of Florida Inc

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1457511164
  NPD
• Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Sebastian, FL
  • NPI 1376421479
  NPD
• Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Melbourne, FL
  • NPI 1417772666
  NPD
• Ante Rudez MD PA

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1356595680
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indian River Memorial Hospital Inc

  dba Cleveland Clinic Indian River Hospital

  • General Acute Care Hospital
  • Vero Beach, FL
  • NPI 1376512988
  Care Compare affiliation

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

{
    "created_epoch": "1424476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1750773255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 S US HIGHWAY 1",
            "address_2": "STE C11",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349828143",
            "telephone_number": "772-466-6855",
            "fax_number": "772-464-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 S US HIGHWAY 1",
            "address_2": "STE C11",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349828143",
            "telephone_number": "772-466-6855",
            "fax_number": "772-464-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONCHAM BRADLEY",
        "first_name": "KIMBERLY",
        "middle_name": "ROSS",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-21",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9187855",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9187855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Florida Woman Care LLC
• Florida Woman Care LLC
• Florida Woman Care, LLC
• Focused ABA LLC
• Nila Folkes
• Forever Loving Hands, Inc
• Fort Pierce Discount Pharmacy, Inc.
• Fort Pierce Family Care, Inc.
• Fort Pierce Health Care Associates LLC (Fort Pierce Health Care)
• Fort Pierce Intermediate Care Center (Fort Pierce Walk-In Medical Clinic)

• Family Nurse Practitioner in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.