Individual provider Active NPI

Courtney Michelle Jay-Bradley, BSN, RN, MSN, FNP-C

  • Internal Medicine Physician
  • Canton, OH
National Provider Identifier
1841059458
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
APRN.CNP.0036051 Issued in OH
Practice address
2600 6TH St SW
Canton, OH 44710-1702
Phone
(330) 363-2180
NPI assigned
Mar 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X APRN.CNP.0036051 OH Primary

Addresses

Primary practice location

2600 6TH St SW
Canton, OH 44710-1702

Mailing address

29 Candlelight LN
Dover, OH 44622-9443
Phone (330) 232-4024

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address courtney.jay-bradley@direct.aultman.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240809000974 OH Practitioner - Nurse Practitioner 2769929652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Physician Professional CorporationGroup PAC ID 2668406059, 143 clinicians

Practice addresses (Care Compare)

2600 6TH SWST
Canton, OH 44710-1702
Phone (330) 363-2180

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Certified Nurse Practitioner, Master of Science - Nursing, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Physician Professional Corporation Internal Medicine CurrentSince May 19, 2024 Accepting new patients

Locations

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1841059458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 CANDLELIGHT LN",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446229443",
            "telephone_number": "330-232-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 6TH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-363-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAY-BRADLEY",
        "first_name": "COURTNEY",
        "middle_name": "MICHELLE",
        "name_prefix": "Miss",
        "credential": "BSN, RN, MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "APRN.CNP.0036051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "courtney.jay-bradley@direct.aultman.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address via Employer",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2600 6th St SW",
            "city": "Canton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "447101702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.