BRADLEY A JOHNSON (NPI# 1326127317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326127317 |
| Entity Type | Individual |
| Full Name | BRADLEY A JOHNSON |
| Credential | MD |
| Practice Address |
411 Hamilton Blvd 1824 Peoria IL 61602-1144 |
| Mailing Address |
10335 N Port Washington Rd 250 Mequon WI 53092-5763 |
| Practice Telephone | 3094949320 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861997975 | Bradley Johnson | Durable Medical Equipment & Medical Supplies | 6489 Endurance Hts, Colorado Springs, CO 80923-5803 | 2018-03-29 |
| 1245641265 | Bradley Curtis Johnson | Orthopaedic Surgery | 39 Congress St Fl 2, Pasadena, CA 91105-3024 | 2014-05-13 |
| 1922443878 | Bradley Scott Johnson | Pharmacist | 2305 Jordan Ln Sw, Huntsville, AL 35805-3322 | 2013-05-06 |
| 1023251642 | Bradley S Johnson | Dentist | 1551 E Morris Blvd, Morristown, TN 37813-5729 | 2009-04-13 |
| 1407023567 | Bradley Duncan Johnson | Psychiatry & Neurology | 617 Hove Ct, Walnut Creek, CA 94598-2325 | 2008-05-08 |
| 1003010596 | Bradley Tyler Johnson | Otolaryngology | 133 Benmore Dr Ste 100, Winter Park, FL 32792-4111 | 2007-06-11 |
| 1568427045 | Bradley P Johnson | Nurse Anesthetist, Certified Registered | 196 North Street, Geneva, NY 14456 | 2006-04-19 |
| 1518931260 | Bradley E Johnson | Dentist | 1016 Nw Newport Ave, Bend, OR 97701-1618 | 2006-02-16 |
| 1710984588 | Bradley Thiren Johnson | Pharmacist | 4010 Aerial Way, Eugene, OR 97402-9757 | 2005-07-07 |
| 1790781516 | Bradley N Johnson | Physical Therapist | 309 S Louisiana St, Plain Dealing, LA 71064-3431 | 2005-06-27 |
| Street Address |
411 HAMILTON BLVD 1824 |
| City | PEORIA |
| State | IL |
| Zip Code | 61602-1144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124030705 | Terry M Brady | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-08-12 |
| 1174692933 | Clinton James Wentz | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-11-07 |
| 1568531382 | Peter Edward Shile | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-11-07 |
| 1700955515 | Harry Robinson Smouse | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-11-07 |
| 1861561672 | Kevin M Fahey | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-11-07 |
| 1265501035 | James L Swischuk | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-11-07 |
| 1477622249 | Michael T Zagardo | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-11-07 |
| 1891864625 | Peter Anthony Williams | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-11-07 |
| 1861561615 | Gary S Zwicky | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-11-07 |
| 1063581882 | Steven J Ullenius | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720574676 | Critical Care Rx, LLC | Pharmacy | 126 Oak St, Peoria, IL 61602 | 2018-07-03 |
| 1235675836 | Cheryl Beckman | Registered Nurse | 211 Fulton Street, Suite 207, One Technology Plaza, Peoria, IL 61602 | 2017-01-06 |
| 1063957942 | Rosemary Ince | Registered Nurse | 211 Fulton St. Suite 207, One Technology Plaza, Peoria, IL 61602 | 2016-12-30 |
| 1962674820 | Lisa Jean Burckhartzmeyer | Psychiatry & Neurology | 228 Ne Jefferson St, Peoria, IL 61602 | 2008-03-31 |
| 1669503587 | Jill Larson | Counselor | 330 Sw Washington Street, Peoria, IL 61602 | 2007-03-09 |
| 1265407399 | Cardiac Consultants Sc | Internal Medicine | 900 Main Street, Suite 320, Peoria, IL 61602 | 2006-02-22 |
| 1013364470 | Rafal Szymczuk | Student in an Organized Health Care Education/Training Program | 900 Main Street, Suite 720, Peoria, IL 61602 | 2016-05-16 |
| 1043693831 | Kari Beth Watts | Family Medicine | 815 Main St, Peoria, IL 61602 | 2015-06-30 |
| 1881072791 | Kristen Dent | Family Medicine | 815 Main St, Peoria, IL 61602 | 2015-05-12 |
| 1023422797 | Andrew Wang | Psychiatry & Neurology | 900 Main St Ste 580, Peoria, IL 61602 | 2014-06-20 |
| Find all providers in zip 61602 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1932490075 | Christine Ann Wigginton | Radiology | 221 Ne Glen Oak Ave Dept Of, Peoria, IL 61636 | 2011-04-24 |
| 1932421591 | Smi Imaging, LLC | Radiology | 9125 W Thunderbird Rd, Suite 105, Peoria, AZ 85381-4920 | 2010-02-24 |
| 1972736163 | Smi Imaging, LLC | Radiology | 9403 W Thunderbird Rd, Peoria, AZ 85381-4825 | 2009-09-03 |
| 1184828360 | Jane Ho Maksimovic | Radiology | 2612 W Newman Pkwy, Peoria, IL 61604-2208 | 2007-06-12 |
| 1124030705 | Terry M Brady | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-08-12 |
| 1275543456 | Kim V. Arellano-villarreal | Radiology | 401 Sw Water St, Peoria, IL 61602-1571 | 2006-08-09 |
| 1386659241 | Central Illinois Radiological Associates, Ltd. | Radiology | Osf St Francis Medical Ctr, 530 N.e. Glen Oak, Peoria, IL 61636-0001 | 2006-07-29 |
| 1538192828 | Central Illinois Radiological Associates, Ltd. | Radiology | 530 Ne Glen Oak Avenue, Peoria, IL 61637 | 2006-07-09 |
| 1265469399 | Brian A Holtan | Radiology | 31003 N 118th Ln, Peoria, AZ 85383-8240 | 2006-06-26 |
| Find all providers in PEORIA | ||||
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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.