NPIMap

Individual provider Active NPI

Amanda Jo Smith-Bradway, D.C

  • Chiropractor
  • Jasper, IN
National Provider Identifier
1881925873
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002498A Issued in IN
Practice address
725 W 6TH St
Jasper, IN 47546-2629
Phone
(812) 345-1930
NPI assigned
Jan 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 08002498A IN
Chiropractor 111N00000X 08002498A IN Primary

Addresses

Primary practice location

725 W 6TH St
Jasper, IN 47546-2629

Mailing address

810 Crestwood Dr
Jasper, IN 47546-8458
Phone (812) 345-1930

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ross P. Hartings Inc. Chiropractor CurrentSince Mar 9, 2020 Accepting new patients

Locations

725 W 6th St
Jasper, IN 47546
Phone (317) 809-7318

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.

NPI Registry JSON

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1881925873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 CRESTWOOD DR",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475468458",
            "telephone_number": "812-345-1930",
            "fax_number": "812-482-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 W 6TH ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462629",
            "telephone_number": "812-345-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-BRADWAY",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "name_prefix": "Miss",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-15",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IN",
            "license": "08002498A",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002498A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.