Phuong Diep Bradford, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11007879 Issued in FL

Practice address

4543 S Manhattan Ave Ste 101
Tampa, FL 33611-2330

Phone

(813) 544-8100

NPI assigned

Oct 21, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tampa General Hospital Hospital, Tampa, FL, CCN 100128

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Advanced Allergy & Asthma Care PA

  • Allergy Physician
  • Pinellas Park, FL
  • NPI 1427161181

  Allergy & Immunology

  Medicare reassignment NPD
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• University Medical Service Association Inc

  • Physical Therapist
  • Tampa, FL
  • NPI 1992742324
  NPD
• University Medical Service Association Inc

  • Neurological Surgery Physician
  • Tampa, FL
  • NPI 1740227966
  NPD (past)

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

• Florida Health Sciences Center Inc

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1235196510
  Care Compare affiliation

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1982203915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4543 S MANHATTAN AVE STE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336112330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4543 S MANHATTAN AVE STE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336112330",
            "telephone_number": "813-544-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6233 66th St N",
            "address_purpose": "LOCATION",
            "city": "Pinellas Park",
            "state": "FL",
            "postal_code": "337815025",
            "country_code": "US",
            "telephone_number": "727-544-8100",
            "fax_number": "727-544-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1823 Health Care Dr Bldg 5",
            "address_purpose": "LOCATION",
            "city": "New Port Richey",
            "state": "FL",
            "postal_code": "346555363",
            "country_code": "US",
            "telephone_number": "727-544-8100",
            "fax_number": "727-544-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2323 Curlew Rd Ste 6D",
            "address_purpose": "LOCATION",
            "city": "Dunedin",
            "state": "FL",
            "postal_code": "346989307",
            "country_code": "US",
            "telephone_number": "727-544-8100",
            "fax_number": "727-544-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Tampa General Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063571",
            "country_code": "US",
            "telephone_number": "813-821-8038",
            "fax_number": "813-974-4325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "PHUONG",
        "middle_name": "DIEP",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "APRN11007879",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11007879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "RJJ5H",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111161400",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pbradford214340@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lynsey Bracken, RN
• Erin Brackett
• Connor Lee Bracy
• Robert P Bradbury, RPH
• Courtney Sandra Braden, LMT
• Shelica Anastari Bradford, PA-C
• Michelle Bradham-Cousar, PHD, CRC, LMHC, NCC
• Bradley D Fouraker MD LLC
• Alayna Nicole Bradley, PA
• Allison Bradley

• Family Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.