Organization Active NPI

Bradberry Chiropractic, P.a.

  • Chiropractor
  • Largo, FL
National Provider Identifier
1821342387
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 10777 Issued in FL
Legal business name
BRADBERRY CHIROPRACTIC, P.A.
Practice address
405 Seminole Blvd
Largo, FL 33770-3620
Phone
(727) 581-2774
Fax
(727) 581-3199
NPI assigned
Nov 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Authorized official

Name
Dr. Douglas Wayne Bradberry, D.C.
Title
President
Phone
(727) 459-6672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH 10777 FL Primary

Addresses

Primary practice location

405 Seminole Blvd
Largo, FL 33770-3620

Mailing address

11566 Declaration Dr
Tampa, FL 33635-6341
Phone (727) 459-6672

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352160000000",
    "number": "1821342387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11566 DECLARATION DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336356341",
            "telephone_number": "727-459-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 SEMINOLE BLVD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703620",
            "telephone_number": "727-581-2774",
            "fax_number": "727-581-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADBERRY CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2012-11-06",
        "status": "A",
        "authorized_official_last_name": "BRADBERRY",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-459-6672",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 10777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.