Individual provider Active NPI

Natasha Shannette Bradley-Davis

  • Licensed Vocational Nurse
  • Sherman, TX
National Provider Identifier
1770130213
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
347152 Issued in TX
Practice address
1212 Park PL
Sherman, TX 75092-3335
Phone
(618) 581-6040
NPI assigned
Aug 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 347152 TX Primary

Addresses

Primary practice location

1212 Park PL
Sherman, TX 75092-3335

Mailing address

1212 Park PL
Sherman, TX 75092-3335
Phone (618) 581-6040

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

State licenses

LicenseStateTypeSpecialty
347152TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1770130213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 PARK PL",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750923335",
            "telephone_number": "618-581-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 PARK PL",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750923335",
            "telephone_number": "618-581-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY-DAVIS",
        "first_name": "NATASHA",
        "middle_name": "SHANNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "347152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.