Shauna S Bradley

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

121919-3501 Issued in UT

Practice address

2078 Prospector Ave
Park City, UT 84060-7321

Phone

(435) 645-7097

Fax

(435) 783-4243

NPI assigned

Jul 5, 2006

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

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992736656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681151",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840681151",
            "telephone_number": "435-645-7097",
            "fax_number": "435-783-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2078 PROSPECTOR AVE",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607321",
            "telephone_number": "435-645-7097",
            "fax_number": "435-783-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "SHAUNA",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "121919-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Watson Allen Bowes III, M.D.
• Shannon Smietana Boxley, LMFT
• Alexander Boyd
• Tamara Bozeman
• Amy Bradford, RN
• Casey Jane Brady, DPT
• Robert S. Briggs, O.D.
• Melissa Struwe Briley, MS, PA-C
• Sarene Brooks, RD
• Broph'S Place, LLC

• Clinical Social Worker in Park City, UT
• Providers in Park City, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.