Individual provider Active NPI

Bridget Gallagher Bradenham, CRNP, FNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1821895269
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP031803 Issued in PA
Practice address
2200 Arch St
Philadelphia, PA 19103-1330
Phone
(215) 561-9100
NPI assigned
Feb 25, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP031803 PA Primary
Registered Nurse 163W00000X RN700484 PA

Addresses

Primary practice location

2200 Arch St
Philadelphia, PA 19103-1330

Mailing address

8113 Ardmore Ave
Wyndmoor, PA 19038-8419
Phone (215) 510-6638

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
RN700484PAMDRegistered Nurse
SP031803PAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1740441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1821895269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8113 ARDMORE AVE",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "190388419",
            "telephone_number": "215-510-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 ARCH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031330",
            "telephone_number": "215-561-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADENHAM",
        "first_name": "BRIDGET",
        "middle_name": "GALLAGHER",
        "credential": "CRNP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP031803",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN700484",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.