Katrina Elizabeth Bradley, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PD14611 Issued in AR

Practice address

2833 Bella Vista Way
Bella Vista, AR 72714-3709

Phone

(479) 876-2153

Fax

(479) 876-2184

NPI assigned

Jul 25, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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 and National Provider Directory roles.

• Arkansas CVS Pharmacy LLC

  • Pharmacy
  • North Little Rock, AR
  • NPI 1760951602
  NPD (past)
• Arkansas CVS Pharmacy, L.L.C.

  • Pharmacy
  • Bella Vista, AR
  • NPI 1396151403
  NPD (past)

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1861979569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2171 BUCK CV",
            "city": "PEA RIDGE",
            "state": "AR",
            "postal_code": "727515000",
            "telephone_number": "479-426-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2833 BELLA VISTA WAY",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727143709",
            "telephone_number": "479-876-2153",
            "fax_number": "479-876-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "KATRINA",
        "middle_name": "ELIZABETH",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-25",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD14611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PD14611",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James M Billis, D.C.
• Jason Blackketter, D.C.
• Linda Lou Boen
• Courtney Selck Book, M.D.
• Stephanie Jane Brackeen, LMT
• Leigh Ann Brasel, P.D.
• Alli Kristen Brooks, PA-C
• Ralph W Brown III, PT
• Burnett Transit Care LLC
• Gracie Anne Campbell, PT, DPT

• Pharmacist in Bella Vista, AR
• Providers in Bella Vista, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; 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.