Cristin Leanne Bradley, AGNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AG01220092 Issued in NC

Practice address

2041 Willow Rd
Greensboro, NC 27406-3831

Phone

(336) 272-9700

NPI assigned

Jan 24, 2022

Sex

Female

Sole proprietor

No

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.

• Randolph Primary Care, PA

  • Durable Medical Equipment & Medical Supplies
  • Asheboro, NC
  • NPI 1528392289

  NC

  Medicare reassignment NPD
• Universal Health Corporation

  • Internal Medicine Physician
  • Roanoke, VA
  • NPI 1407117625

  NC

  Medicare reassignment NPD

Medicare fee-for-service enrollment

Enrolled in NC

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

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 3, 2024.

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1962154658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CHURCH AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111906",
            "telephone_number": "540-769-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 WILLOW RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274063831",
            "telephone_number": "336-272-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "CRISTIN",
        "middle_name": "LEANNE",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-24",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "AG01220092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Chyrisse Kaiulani Bracken, PA-C
• Lisa Eileen Bracken, LCSW
• Clark Kennard Brackney, DPM
• Lindsey Braddock, MS, LAT, ATC
• Allyson Bradley
• Ellen Bradley
• Linda Bradley
• Marquis Bradley
• Precious Jaleesa Bradley, CD(DONA)
• Robert Bradley, LAC, LMBT

• All providers in Greensboro, NC
• Primary Care Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.