Brad E McCollom DO PA

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

OS9270 Issued in FL

Legal business name

BRAD E MCCOLLOM DO PA

Practice address

7764 Bay Street
Sebastian, FL 32958

Phone

(772) 581-8075

Fax

(772) 581-8097

NPI assigned

Dec 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Brad E McCollom, DONPI 1548264385

Title

President

Phone

(772) 581-8075

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brad E. McCollom, DO

  • Neurological Surgery Physician
  • Sebastian, FL
  • NPI 1548264385

  Neurological Surgery

  NPD (past) Authorized official

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1770767253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "787 37TH ST",
            "address_2": "SUITE E220",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607305",
            "telephone_number": "772-581-8075",
            "fax_number": "772-581-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7764 BAY STREET",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "32958",
            "telephone_number": "772-581-8075",
            "fax_number": "772-581-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAD E MCCOLLOM DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "MCCOLLOM",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-581-8075",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "OS9270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "K6779",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey E Blossom, RPH
• Bloujay Consulting & Management Services, LLC.
• Stephen Lee Blythe, D.O.
• Celeste Angelle Bode, APRN
• Kaley Boucher, CRNA
• Valerie Rose Brady
• Kerrie Brandes, APRN, FNP-C
• Stephanie Braun, MA, LMFT
• Breeze Pelvic Health LLC
• Lauren Breuer, PT

• All providers in Sebastian, FL
• Neurological Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.