Tiffany Bradley, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20227 Issued in NV

Practice address

3131 La Canada St Ste 200
Las Vegas, NV 89169-8204

Phone

(702) 369-5582

Fax

(702) 650-5148

NPI assigned

Apr 4, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Intermountain Medical Holdings Nevada Inc

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1245997279

  Family Medicine

  Medicare reassignment NPD
• Med-Care Providers LLC

  • Primary Care Nurse Practitioner
  • Las Vegas, NV
  • NPI 1508630542
  Medicare reassignment NPD
• Healthcare Partners Medical Group Coats LTD

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1487631917
  NPD
• Intermountain Medical Holdings Nevada Inc

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1689882557
  NPD

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1962935288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3343",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 LA CANADA ST STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891698204",
            "telephone_number": "702-369-5582",
            "fax_number": "702-650-5148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4275 Burnham Ave Ste 255",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891198204",
            "country_code": "US",
            "telephone_number": "702-369-0088",
            "fax_number": "702-893-4913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "TIFFANY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "20227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962935288",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "20227",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sequoia Bradley
• Shera Deanne Bradley, PH.D.
• Shira Bradley
• Sybil Theola Bradley
• Tierra Bradley
• Uriah Bradley, BCBA
• Tracy D Bradshaw-Taylor
• Brandi J Bradshaw, DC
• Bret Bradshaw
• Devin Bradshaw, DO

• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.