Active NPI
Robyn Bradford, LPN
- Licensed Practical Nurse
- Dayton, OH
National Provider Identifier
1790908150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN-103668
- Practice address
- 4090 Locus Bend Dr
Dayton, OH 45440-4069 - Phone
- (937) 776-6292
- NPI assigned
- Apr 11, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN-103668 | OH | Primary |
Addresses
Primary practice location
4090 Locus Bend Dr
Dayton, OH 45440-4069
Mailing address
PO Box 167
Bellbrook, OH 45305-0167
Phone (937) 776-6292
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2578652 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN-103668 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790908150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 167",
"city": "BELLBROOK",
"state": "OH",
"postal_code": "453050167",
"telephone_number": "937-776-6292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4090 LOCUS BEND DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "454404069",
"telephone_number": "937-776-6292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADFORD",
"first_name": "ROBYN",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN-103668",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2578652",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.