Mark Bradford, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C0003213 Issued in MD

Practice address

1 Texas Station CT
Timonium, MD 21093-8286

Phone

(410) 683-2120

Fax

(410) 683-2130

NPI assigned

Jun 3, 2006

Last updated

Feb 17, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424131200000",
    "number": "1831137611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 KERNAN DR",
            "address_2": "1ST FLOOR ORTHOPAEDICS SUITE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212076665",
            "telephone_number": "410-448-6375",
            "fax_number": "410-448-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TEXAS STATION CT",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210938286",
            "telephone_number": "410-683-2120",
            "fax_number": "410-683-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2015-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0003213",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0003213",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "COOO3213",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP UMOA",
            "identifier": "665L",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1831137611",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen David Bonwit, PTA,RN
• Austin Joseph Schumann Bowden, DDS
• Tracy Austin Bowden, D.D.S.
• Benjamin Bowman
• Mark Aleksander Boyland, DPT
• Michael Underwood Brady, M.D.
• Tammy Brady, PTA
• Michele Braerman, RDH BSDH
• Erika Jordan Brager, DPT
• Julia F Brand, D.D.S.

• Medical Physician Assistant in Timonium, MD
• Providers in Timonium, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.