Nicholas Bradlee DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

NB000558 Issued in MI

Legal business name

NICHOLAS BRADLEE DPM

Practice address

28565 Ryan Road
Warren, MI 48092

Phone

(586) 751-3533

Fax

(586) 751-1817

NPI assigned

Oct 27, 2006

Organization subpart

No

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

Authorized official

Name

Nicholas Bradlee, DPM

Title

Owner

Phone

(586) 751-3533

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972689586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1227",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480901227",
            "telephone_number": "586-751-3533",
            "fax_number": "586-751-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28565 RYAN ROAD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48092",
            "telephone_number": "586-751-3533",
            "fax_number": "586-751-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS BRADLEE DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRADLEE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-751-3533",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "NB000558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8505050",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5635277",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacie Ann Newberry, BA
• Huong Quynh Nguyen, PA-C
• Shawn Nguyen, DDS
• Vivian Nguyen, PA-S
• Jacqueline Nicastri, MA, LLPC, NCC
• Frederick Scott Nichols, D.O.
• Alana Maria Nicolazzo, MA. LLPC
• Amy Elizabeth Nicolopoulos
• Stephanie Ann Nienow
• Lydia Nierman Cornwall

• Podiatrist in Warren, MI
• Providers in Warren, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.