Kimberly Humphrey Brailsford

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

390720 Issued in NC

Practice address

208 Mercer Road
Elizabethtown, NC 28337

Phone

(910) 862-8181

NPI assigned

May 25, 2018

Last updated

May 25, 2018By the provider in NPPES

Sex

Female

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1962993907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 HORSESHOE LN",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284258229",
            "telephone_number": "910-352-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MERCER ROAD",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "28337",
            "telephone_number": "910-862-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAILSFORD",
        "first_name": "KIMBERLY",
        "middle_name": "HUMPHREY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "390720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHA BLS",
            "identifier": "09170607461",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBCOT",
            "identifier": "390720",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBOT",
            "identifier": "11366",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bladen Healthcare, LLC (Cape Fear Valley - Bladen Urgent Care)
• Bladen Medical Associates
• Bladen Transit LLC
• Bladen Urgent Care (Surgical Specialist for Bladen County)
• Christine Michelle Borza, PTA
• Deborah H Brisson
• Cynthia Britt
• Jerri Ann Uhlir Britt, PHARM D
• Manetta Brown
• Shelley Yvonne Brown, NP-C

• Occupational Therapy Assistant in Elizabethtown, NC
• Providers in Elizabethtown, NC by specialty
• Occupational Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.