John C. Bradley, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R118379 Issued in MD

Practice address

9104 Market St
Wilmington, NC 28411-7994

Phone

(301) 694-3400

Fax

(301) 694-3620

NPI assigned

Nov 29, 2006

Last updated

Apr 30, 2011By 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 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• American Anesthesiology of Maryland, P.C.

  • Anesthesiology Physician
  • Towson, MD
  • NPI 1033161286

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Chevy Chase Anesthesia LLC

  • Anesthesiology Physician
  • Frederick, MD
  • NPI 1538158977
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304121600000",
    "number": "1871660555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18139",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276198139",
            "telephone_number": "636-549-2380",
            "fax_number": "314-569-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9104 MARKET ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284117994",
            "telephone_number": "301-694-3400",
            "fax_number": "301-694-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "JOHN",
        "middle_name": "C.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2011-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R118379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "S417 0030",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD (GRP PTAN DD6120)",
            "identifier": "P00745073",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "KBC1CH",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD (GRP PTAN CJ8689)",
            "identifier": "P00728709",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R118379",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403621200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Elizabeth Braa, MSW, LCSWA
• Ryan Allen Brabrand, LCAS-A
• Paige Bracey, LCSWA
• Shannon Bracken
• Jeremy Justin Bradford, PT, DPT
• Karimah Iona Bradley, LCAS, LCMHC
• Kaydence Alexandra Bradley
• Lindsey Michelle Bradley
• Michael Bradley, ED.D.
• Stacey Ann Bradley, ACNPC-AG

• Certified Registered Nurse Anesthetist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2011; 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.