Shevoann Bradford

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

44020 Shasta Dr
Desert Center, CA 92239-3615

Phone

(760) 534-1787

NPI assigned

Jan 17, 2024

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 22, 2024.

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1902667959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44020 SHASTA DR",
            "city": "DESERT CENTER",
            "state": "CA",
            "postal_code": "922393615",
            "telephone_number": "760-534-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44020 SHASTA DR",
            "city": "DESERT CENTER",
            "state": "CA",
            "postal_code": "922393615",
            "telephone_number": "760-534-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "SHEVOANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.