CHARLES BRADFORD (NPI# 1194281584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194281584 |
| Entity Type | Individual |
| Full Name | CHARLES BRADFORD |
| Credential | FNP-BC |
| Practice Address |
3660 Vista Ave Saint Louis MO 63110-2540 |
| Practice Telephone | 3149778462 |
| Practice Fax Number | 3147718575 |
| Mailing Telephone | 3149778462 |
| Mailing Fax Number | 3147718575 |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2020-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.018613 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2018033937 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518321868 | Charles Bradford | Counselor | 609 Northshore Dr, Bellingham, WA 98226-4414 | 2016-04-12 |
| 1811215643 | Charles Shannon Bradford Jr. | Internal Medicine | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2010-05-04 |
| 1700805082 | Charles Raymond Bradford IIi | Family Medicine | 508 Harley St, Suite D, Scottsboro, AL 35768-4294 | 2006-07-18 |
| 1427085133 | Charles Raymond Bradford Iv | Family Medicine | 508 Harley St, Suite B, Scottsboro, AL 35768-4294 | 2006-06-27 |
| Street Address |
3660 VISTA AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-2540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871582692 | Alan P K Wild | Otolaryngology | 3660 Vista Ave, Ste. 312, Saint Louis, MO 63110 | 2005-10-14 |
| 1922627207 | Emily Bayliss Worrall | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-16 |
| 1508485988 | Jackson Jeffrey Meland | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-15 |
| 1316566748 | Katherine Elizabeth Oberhelman | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-15 |
| 1063031664 | Elizabeth Jane De Quetteville Robin | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-14 |
| 1053930586 | Tim Brotherton Jr. | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-14 |
| 1285253328 | Eugene Chiemeka Nwankwo Jr. | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-09 |
| 1124647318 | Christian Hendrix | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-08 |
| 1851920730 | Kellen J Smutz | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-03 |
| 1487283172 | Abhinav Reddy | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720816 | Blake Christian Cory | Nurse Practitioner | 615 S Ballas Rd # 2015, Saint Louis, MO 63122-5314 | 2020-11-08 |
| 1265032346 | Sara Lynn Gillespie | Nurse Practitioner | 2424 S 9th St Apt 215, Saint Louis, MO 63104-4717 | 2020-10-28 |
| 1174123509 | Megan Ashley Wagner | Nurse Practitioner | 10012 Kennerly Rd Ste 406, Saint Louis, MO 63128-2197 | 2020-10-26 |
| 1467059972 | Anissa Rasul | Nurse Practitioner | 10631 Thayer Dr, Saint Louis, MO 63123-6018 | 2020-10-07 |
| 1124635388 | Brittney Sherrell Burks | Nurse Practitioner | 10314 Briar Hollow Dr Apt 7, Saint Louis, MO 63146-5777 | 2020-09-30 |
| 1629684865 | Nicole Burdge | Nurse Practitioner | 9230 Laurel Hill Dr, Saint Louis, MO 63126-2820 | 2020-09-22 |
| 1932724614 | Oluwatoyin Olufunke Adegboyega | Nurse Practitioner | 3318 Saint Vincent Ave, Saint Louis, MO 63104-1338 | 2020-06-09 |
| 1497376487 | Jessica A Spring | Nurse Practitioner | 6023 Lansdowne Ave, Saint Louis, MO 63109-2243 | 2020-04-30 |
| 1932728466 | Lucy Wachuka Kamau | Nurse Practitioner | 4412 Clarence Ave, Saint Louis, MO 63115-3108 | 2020-04-14 |
| 1275169567 | Lindsay Jones | Nurse Practitioner | 1115 Olivette Executive Pkwy Ste 100, Saint Louis, MO 63132-3265 | 2020-03-18 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
Please comment or provide details below to improve the information on CHARLES BRADFORD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.