Kathy Y Bradford, ARNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP60172219 Issued in WA

Practice address

1420 Roosevelt Ave Ste 4
Mount Vernon, WA 98273-2687

Phone

(360) 899-4086

Fax

(360) 899-4124

NPI assigned

Sep 27, 2010

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 3

Other names 1

• Kathy Y Plante Former name

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Cascade Clinic Walk in and Primary Care LLC

  • Primary Care Clinic/Center
  • Mount Vernon, WA
  • NPI 1609121854
  Medicare reassignment NPD Authorized official
• Puget Sound Work Injury Clinic, LLC

  • Clinic/Center
  • Bremerton, WA
  • NPI 1629636055
  NPD Authorized official
• Premier Diabetes Care, PLLC

  • Adult Health Nurse Practitioner
  • Arlington, WA
  • NPI 1235696568
  NPD (past)

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1871802769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 ROOSEVELT AVE STE 4",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732687",
            "telephone_number": "360-899-4086",
            "fax_number": "360-899-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 ROOSEVELT AVE STE 4",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732687",
            "telephone_number": "360-899-4086",
            "fax_number": "360-899-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "KATHY",
        "middle_name": "Y",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-27",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP60172219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12194699",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2024980",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0296462",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "PLANTE",
            "middle_name": "Y",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melinda Buttles Bowen, M.A., CCC-SLP
• Kevin Roy Bowman, M.D.
• Rae Boyd, APRN
• Holly Rae Braaten, CNM
• Andrea L Bradford, LICSW
• Abigail Bradley
• Melissa Bernadette Brandon-Doerge, LMP
• Betty Sue Branscom, RN
• Matthew Forrest Brasfield, BS, SUDPT, AAC, CPC
• Charleen Renee Bray, CDPT

• Adult Health Nurse Practitioner in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Adult Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.