Active NPI
Jessica Bradley, RD
- Registered Dietitian
- Conway, AR
National Provider Identifier
1841700879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- PLD230
- Practice address
- 1500 Museum Rd Ste 104
Conway, AR 72032-4761 - Phone
- (501) 932-9010
- Fax
- (501) 932-0020
- NPI assigned
- Oct 4, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | PLD230 | AR | Primary |
Addresses
Primary practice location
1500 Museum Rd Ste 104
Conway, AR 72032-4761
Mailing address
PO Box 497
Augusta, AR 72006-0497
Phone (870) 347-2534
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
| License | State | Type | Specialty |
|---|---|---|---|
| PLD230 | AR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507075200000",
"number": "1841700879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 497",
"city": "AUGUSTA",
"state": "AR",
"postal_code": "720060497",
"telephone_number": "870-347-2534",
"fax_number": "870-347-2023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 MUSEUM RD STE 104",
"city": "CONWAY",
"state": "AR",
"postal_code": "720324761",
"telephone_number": "501-932-9010",
"fax_number": "501-932-0020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "JESSICA",
"name_prefix": "Ms.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-04",
"last_updated": "2017-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AR",
"license": "PLD230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.