Jimmie Braxton Bradley, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH0002687 Issued in FL

Practice address

2306 Cleveland Ave
Fort Myers, FL 33901-3540

Phone

(239) 332-1311

Fax

(239) 332-7749

NPI assigned

Mar 9, 2006

Last updated

Aug 3, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• J. B. Bradley, D.C., P.a.

  • Chiropractor
  • Fort Myers, FL
  • NPI 1952611253
  Authorized official Same address or phone
• Beacon Chiropractic, PLLC

  • Medical Specialty Clinic/Center
  • Fort Myers, FL
  • NPI 1548707490
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1952379794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 CLEVELAND AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339013540",
            "telephone_number": "239-332-1311",
            "fax_number": "239-332-7749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 CLEVELAND AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339013540",
            "telephone_number": "239-332-1311",
            "fax_number": "239-332-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "JIMMIE",
        "middle_name": "BRAXTON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0002687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "050637100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley M. Woodham, D.M.D., P.a. (Edgewater Family Dentistry)
• Bradley P Dilling, DMD, PA
• Bradley P Dilling, DMD, PA (Avalon Dental)
• Dawn Bradley, ARNP
• Erin Bradley, DOT
• Nina Grace Bradley, D.O.
• Carol Bradshaw
• Jeremi Tricia Braga, NNP-BC
• Mark Braganza
• Nancy Bragaw Patten

• Chiropractor in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; 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.