MR. ROBBIE L BRADLEY (NPI# 1295890762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295890762 |
| Entity Type | Individual |
| Full Name | MR. ROBBIE L BRADLEY |
| Credential | PAC |
| Practice Address |
6199 W Gulf To Lake Hwy Crystal River FL 34429-2679 |
| Practice Telephone | 3527950644 |
| Practice Fax Number | 3527952950 |
| Mailing Telephone | 3527950644 |
| Mailing Fax Number | 3527952950 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2009-08-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | PAC0001893 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 290310500 | 05 |
| Street Address |
6199 W GULF TO LAKE HWY |
| City | CRYSTAL RIVER |
| State | FL |
| Zip Code | 34429-2679 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073695755 | Jim C Dickert | Family Medicine | 6199 W Gulf To Lake Hwy, Crystal River, FL 34429-2679 | 2006-10-20 |
| 1770128472 | Meadowcrest Molecular Diagnostics LLC | Clinical Medical Laboratory | 6199 W Gulf To Lake Hwy, Crystal River, FL 34429-2679 | 2019-11-18 |
| 1346608742 | Meadowcrest Physicians Partners LLC | Family Medicine | 6199 W Gulf To Lake Hwy, Crystal River, FL 34429-2679 | 2016-02-01 |
| 1093135667 | Amanda Carroll Dickert | Nurse Practitioner | 6199 W Gulf To Lake Hwy, Crystal River, FL 34429-2679 | 2014-04-22 |
| 1427342245 | Alex Jonathan Dickert | Family Medicine | 6199 W Gulf To Lake Hwy, Crystal River, FL 34429-2679 | 2011-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093324386 | Sydney M Mergler | Specialist/Technologist | 315 Ne 10th St, Crystal River, FL 34429 | 2020-07-23 |
| 1497255814 | Plantation Medical Care, Pa | Clinic/Center | 9030 W Fort Island Trl Ste 11b, Crystal River, FL 34429 | 2018-02-13 |
| 1356864599 | Jeri Leigh Anderson | Family Medicine | 6199 W. Gulf To Lake Hwy, Crystal River, FL 34429 | 2017-07-19 |
| 1982011706 | Bambi Ann Heyer | Nurse Practitioner | 659 Ne Hwy 19 Unit 1, Crystal River, FL 34429 | 2014-07-14 |
| 1982977120 | Life Soulutions | Community/Behavioral Health | 427 Ne 3rd St Ste C, Crystal River, FL 34429 | 2012-02-20 |
| 1073844296 | Richard C Swanson,dmd Pa | Clinic/Center | 1815 Se Hwy 19, Crystal River, FL 34429 | 2010-01-28 |
| 1710116520 | Albert M. Boholst | Surgery | 730 S.e. 5th Terrace, Crystal River, FL 34429 | 2009-07-14 |
| 1033353453 | Claire Annette Wirt | Mechanotherapist | 1925 Se Hwy 19, Crystal River, FL 34429 | 2009-04-29 |
| 1811134067 | John D. Hosner, D.d.s., P.a. | Dentist | 1118 N. Suncoast Blvd., Crystal River, FL 34429 | 2009-01-09 |
| 1396981528 | Meadowcrest Family Physicians, P.a. | Family Medicine | 1250 N Vantage Pt Dr, Crystal River, FL 34429 | 2008-12-17 |
| Find all providers in zip 34429 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356864599 | Jeri Leigh Anderson | Family Medicine | 6199 W. Gulf To Lake Hwy, Crystal River, FL 34429 | 2017-07-19 |
| 1306231212 | Ryan Spencer Dickert | Family Medicine | 1250 N Vantage Point Dr, Crystal River, FL 34429-5736 | 2015-03-30 |
| 1356656813 | Absolute Medical Services, Pa | Family Medicine | 521 Se Fort Island Trl, Suite E, Crystal River, FL 34429-8904 | 2010-08-09 |
| 1003041419 | Rolf Lyon Urgent Care LLC | Family Medicine | 155 Se Highway 19, Crystal River, FL 34429-4838 | 2009-05-29 |
| 1396981528 | Meadowcrest Family Physicians, P.a. | Family Medicine | 1250 N Vantage Pt Dr, Crystal River, FL 34429 | 2008-12-17 |
| 1518030311 | Mullally Holdings Plc | Family Medicine | 11515 W Emerald Oaks Dr, Crystal River, FL 34428-2815 | 2006-11-17 |
| 1043398266 | Rolf C Lyon | Family Medicine | 155 S.e. Hwy 19, Crystal River, FL 34429-4838 | 2006-11-02 |
| 1073695755 | Jim C Dickert | Family Medicine | 6199 W Gulf To Lake Hwy, Crystal River, FL 34429-2679 | 2006-10-20 |
| 1821109455 | David Irvine | Family Medicine | 700 Se 5th Ter Ste 7, Crystal River, FL 34429-4876 | 2006-08-31 |
| 1346283041 | James Arthur Derrenbacker II | Family Medicine | 1669 S. E. Highway 19 Seven Rivers Rehab & Wound Center, Crystal River, FL 34429 | 2006-06-13 |
| Find all providers in CRYSTAL RIVER | ||||
| City | CRYSTAL RIVER |
| Zip Code | 34429 |
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| 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.