Organization Active NPI

Laura a Bradford MD PA

  • Obstetrics & Gynecology Physician
  • Fort Worth, TX
National Provider Identifier
1831490747
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
J4000 Issued in TX
Legal business name
LAURA A BRADFORD MD PA
Practice address
1425 8TH Ave
Fort Worth, TX 76104-4151
Phone
(817) 926-4118
Fax
(817) 926-4362
NPI assigned
Nov 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Authorized official

Name
Dr. Laura Ann Bradford, M.D.NPI 1649228115
Title
Owner
Phone
(817) 926-4118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X J4000 TX Primary

Addresses

Primary practice location

1425 8TH Ave
Fort Worth, TX 76104-4151

Mailing address

1425 8TH Ave
Fort Worth, TX 76104-4151
Phone (817) 926-4118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101110001368 TX Part B Supplier - Clinic/Group Practice 3072708445 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Worth, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2208101Laura Bradford, MD1425 8TH Ave Suite B, Fort Worth, TX 76104Certificate of waiverJan 3, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293494400000",
    "number": "1831490747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044151",
            "telephone_number": "817-926-4118",
            "fax_number": "817-926-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044151",
            "telephone_number": "817-926-4118",
            "fax_number": "817-926-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA A BRADFORD MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-12-28",
        "status": "A",
        "authorized_official_last_name": "BRADFORD",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-926-4118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "J4000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.