Michelle Ann Bradley

Primary specialty

OpticianTaxonomy code 156FX1800X

License

5586 Issued in FL

Practice address

751 Oak St Ste 200
Jacksonville, FL 32204-3361

Phone

(904) 634-1040

Fax

(904) 634-0109

NPI assigned

Oct 30, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Hanley Optical LLC

  • Optician
  • Jacksonville, FL
  • NPI 1598351181
  NPD (past) Authorized official

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1790252583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 E BANISTER RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923028",
            "telephone_number": "904-982-9917",
            "fax_number": "904-634-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 OAK ST STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043361",
            "telephone_number": "904-634-1040",
            "fax_number": "904-634-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "5586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darbrisha Bradley
• David Rishard Bradley
• Julie Ann Bradley, M.D.
• Lauren Bradley
• Michael E Bradley, OTR/L
• Morgan Bradley
• Rolinda R Bradley, MA
• Sarah Bradley, MSW
• Sasha N Bradley
• Tajonda Bradley, RN

• Optician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Optician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.