NPIMap

Organization Active NPI

Bradley Free Clinic of Roanoke Valley

Doing business as Bradley Free Clinic

  • Primary Care Clinic/Center
  • Roanoke, VA
National Provider Identifier
1902157712
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
BRADLEY FREE CLINIC OF ROANOKE VALLEY
Doing business as
Bradley Free Clinic
Practice address
1240 3Rd St SW
Roanoke, VA 24016-4612
Phone
(540) 344-5156
Fax
(540) 777-0726
NPI assigned
Sep 20, 2012
Last updated
Feb 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Authorized official

Name
James Black
Title
Pharmacist in Charge
Phone
(540) 344-5156

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary
Pharmacy 333600000X 0201002648 VA
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

1240 3Rd St SW
Roanoke, VA 24016-4612

Mailing address

1240 3Rd St SW
Roanoke, VA 24016-4612
Phone (540) 344-5156

Other identifiers 1

IdentifierTypeStateIssuer
2164384OtherPK

Other names 1

  • BRADLEY FREE CLINIC Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D0859648Bradley Free Clinic of Roanoke Valley1240 3Rd Street SW, Roanoke, VA 24016Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1240 3rd St SW
Roanoke, VA 24016
Phone (540) 344-5156

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18289/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1902157712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 3RD ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164612",
            "telephone_number": "540-344-5156",
            "fax_number": "540-777-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 3RD ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164612",
            "telephone_number": "540-344-5156",
            "fax_number": "540-777-0726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY FREE CLINIC OF ROANOKE VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "540-344-5156"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "0201002648",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2164384",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRADLEY FREE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BRADLEY FREE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.