Individual provider Active NPI

Stephanie Bradley, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Manchester, NH
National Provider Identifier
1982081840
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
047273-23 Issued in NH
Practice address
445 Cypress St Ste 8
Manchester, NH 03103-3600
Phone
(603) 668-4079
NPI assigned
Apr 29, 2015
Last updated
Jul 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 047273-23 NH Primary

Addresses

Primary practice location

445 Cypress St Ste 8
Manchester, NH 03103-3600

Mailing address

445 Cypress St Ste 8
Manchester, NH 03103-3600
Phone (603) 668-4079

Other practice location 1

105 Pleasant St
Concord, NH 03301-3852
Phone (603) 271-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20200727002756 NH Practitioner - Nurse Practitioner 2264856053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 622-6484

One Elliot Way
100 Elliot Cardiovascular Consultants
Manchester, NH 03103-3502
Phone (603) 627-1669

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047273-23NHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Professional Services CurrentSince Jul 13, 2020 Accepting new patients
Elliot Professional Services PastSince Jul 27, 2020 Accepting new patients

Locations

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

1 Elliot Way
Ste 8
Manchester, NH 03103

445 Cypress St
Ste 8
Manchester, NH 03103
Phone (603) 552-1670

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1982081840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 CYPRESS ST STE 8",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033600",
            "telephone_number": "603-668-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 CYPRESS ST STE 8",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033600",
            "telephone_number": "603-668-4079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Pleasant St",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NH",
            "postal_code": "033013852",
            "country_code": "US",
            "telephone_number": "603-271-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "STEPHANIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "047273-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.