DR. DEREK DAVID BRADLEY (NPI# 1306263728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306263728 |
| Entity Type | Individual |
| Full Name | DR. DEREK DAVID BRADLEY |
| Credential | M.D. |
| Practice Address |
5955 Zeamer Ave Jber AK 99506-3702 |
| Practice Telephone | 9075807246 |
| Mailing Telephone | 9075807246 |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2020-08-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
28755 | NE | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 782344504 | 8018240487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518596139 | Derek Thomas Bradley | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-06 |
| 1609026673 | Derek Bradley | Counselor | 201 W Springdale Ave, Knoxville, TN 37917-5158 | 2008-09-25 |
| Street Address |
5955 ZEAMER AVE |
| City | JBER |
| State | AK |
| Zip Code | 99506-3702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225031768 | Robert Fenton Tyree | Family Medicine | 5955 Zeamer Ave, Jber, AK 99506-3702 | 2005-05-28 |
| 1457985210 | Allison Nicole Womble | Pharmacist | 5955 Zeamer Ave, Jber, AK 99506-3702 | 2020-03-02 |
| 1982249579 | Nicolas Araiza Jr. | Social Worker | 5955 Zeamer Ave, Jber, AK 99506-3702 | 2019-11-07 |
| 1235772732 | Sean Michael Batzer | Physical Therapist | 5955 Zeamer Ave, Jber, AK 99506-3702 | 2019-10-28 |
| 1912540295 | Melody Megan Thompson | Nurse Practitioner | 5955 Zeamer Ave, Jber, AK 99506-3702 | 2019-10-19 |
| 1932752771 | Kevin T Watanabe | Dietitian, Registered | 5955 Zeamer Ave, Jber, AK 99506-3702 | 2019-07-22 |
| 1851853048 | Jordan Matthew Cate | Military Health Care Provider | 5955 Zeamer Ave, Jber, AK 99506-3702 | 2019-04-05 |
| 1669933719 | Keith Happawana | Counselor | 5955 Zeamer Ave, Jber, AK 99506-3702 | 2019-03-29 |
| 1104303320 | Luis Baltazar Baptista | Military Health Care Provider | 5955 Zeamer Ave, Jber, AK 99506-3702 | 2018-07-20 |
| 1134611213 | Luke Acker | Psychologist | 5955 Zeamer Ave, Jber, AK 99506-3702 | 2018-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538797279 | Mark Pulver | Social Worker | 673mdg, Zeamer Avenue, Joint Base Elmendorf-richardson, AK 99506 | 2020-03-30 |
| 1871052837 | Ryan Kenny Zarnowski | Dentist | 673 Mdg, 5955 Zeamer Avenue, Jber, Ak 99506, Apo, AA 99506 | 2019-03-18 |
| 1679056659 | Bennett Robert Stadler | Physician Assistant | 673 Mdg 5955 Zeamer Avenue, Jber, AK 99506 | 2018-09-14 |
| 1437678687 | Mary Ann Barnard | Nurse Practitioner | Joint Base Elmendorf-richardson Hospital, 5955 Zeamer Ave, Anchorage, AK 99506 | 2017-09-19 |
| 1205375698 | Kuuipo Lau | Social Worker | 673d Mdg, 5955 Zeamer Ave., Jber, AK 99506 | 2017-02-17 |
| 1427434315 | Vance Knauer | Dentist | 673mdg 5955 Zeamer Ave, Jber, AK 99506 | 2015-08-03 |
| 1295112159 | Jacob Eby | Pediatrics | 673 Mdg 5955 Zeamer Ave, Jber, AK 99506 | 2015-04-29 |
| 1174956338 | Scott M Cheney | Physical Therapist | 673mdg, 5955 Zeamer Ave, Jber, AK 99506 | 2013-08-12 |
| 1518305580 | Jennifer Lynn Robison | Physician Assistant | 65955 Zeamer Avenue, Jber, AK 99506 | 2013-06-12 |
| 1588939664 | Paul Aaron Garrett | Emergency Medicine | 673rd Mdg, 5955 Zeamer Avenue, Jber, Apo, AA 99506 | 2012-03-21 |
| Find all providers in zip 99506 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508321639 | Giving Hope, LLC | Anesthesiology | 2000 Abbott Rd # A2, Anchorage, AK 99507-3878 | 2019-02-03 |
| 1790112506 | Hyun Sun Chung | Anesthesiology | 427 E Fireweed Ln, Anchorage, AK 99503-2111 | 2013-10-11 |
| 1922338854 | Alaska Spine & Pain Center, LLC | Anesthesiology | 500 E Benson Blvd Ste 103, Anchorage, AK 99503 | 2009-12-24 |
| 1619203585 | Northern Lights Pain Management LLC | Anesthesiology | 1320 22nd Ave, Fairbanks, AK 99701-6516 | 2009-10-27 |
| 1538338132 | Interventional Pain Consultants of Alaska | Anesthesiology | 2751 Debarr Rd Ste B380, Anchorage, AK 99508-6811 | 2008-02-27 |
| 1548300205 | Nichelle Cook Renk | Anesthesiology | 2000 Abbott Rd Ste A2, Anchorage, AK 99507-3878 | 2007-02-08 |
| 1518980556 | Jon A Hinman | Anesthesiology | 3035 Palmer-wasilla Hwy, Unit 501, Wasilla, AK 99654 | 2006-07-25 |
| 1437170586 | Grant T Roderer | Anesthesiology | 1917 Abbott Rd, Suite 100, Anchorage, AK 99507 | 2006-07-22 |
| 1831145929 | Mahmood Ahmad | Anesthesiology | 4050 Lake Otis Pkwy, Suite 107, Anchorage, AK 99508-5223 | 2006-05-26 |
| 1417200551 | Integrative Pain Center of Alaska, LLC | Anesthesiology | 1275 Sadler Way, Suite 101, Fairbanks, AK 99701-3171 | 2012-10-25 |
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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.