BENJAMIN BRADLEY (NPI# 1710524152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710524152 |
| Entity Type | Individual |
| Full Name | BENJAMIN BRADLEY |
| Credential | PMHNP |
| Practice Address |
4100 College Ave Ellicott City MD 21043-5506 |
| Mailing Address |
5938 Talbot Dr Ellicott City MD 21043-7199 |
| Practice Telephone | 9723100513 |
| Mailing Telephone | 9723100513 |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2019-12-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
2019074346 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912431941 | Benjamin Thomas Bradley | Student in an Organized Health Care Education/Training Program | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2017-04-17 |
| 1730518788 | Benjamin Bradley | Nurse Practitioner | 109 W 6th St, Okmulgee, OK 74447-5015 | 2013-11-09 |
| 1821425489 | Benjamin Bradley | Physician Assistant | 707 E Main St, Middletown, NY 10940-2650 | 2013-09-27 |
| 1548546435 | Benjamin Bradley | Physician Assistant | 12586 Avenue 408, Cutler/orosi, CA 93647-9454 | 2011-10-24 |
| Street Address |
4100 COLLEGE AVE |
| City | ELLICOTT CITY |
| State | MD |
| Zip Code | 21043-5506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851324164 | Sheppard Pratt Health System, Inc. | Psychiatric Hospital | 4100 College Ave, Ellicott City, MD 21041-0836 | 2006-07-09 |
| 1801379094 | Tuerk House Inc | Substance Abuse Rehabilitation Facility | 4100 College Ave, Ellicott City, MD 21043-5506 | 2018-09-13 |
| 1992107726 | Tuerk House, Inc. | Substance Abuse Rehabilitation Facility | 4100 College Ave, Ellicott City, MD 21043-5506 | 2014-09-24 |
| 1700287315 | Tuerk House, Inc. | Community/Behavioral Health | 4100 College Ave, Bldg. 8, Ellicott City, MD 21043-5506 | 2014-09-15 |
| 1023445772 | Ameya Umakant Amritwar | Psychiatry & Neurology | 4100 College Ave, Ellicott City, MD 21043-5506 | 2013-09-26 |
| 1407143993 | Noella Yefon Shadzeka | Physician Assistant | 4100 College Ave, Ellicott City, MD 21043-5506 | 2011-07-05 |
| 1346553039 | Sameer R. Patel | Psychiatry & Neurology | 4100 College Ave, Ellicott City, MD 21043-5506 | 2010-07-22 |
| 1104053362 | Sandra Onyeagoro | Psychiatry & Neurology | 4100 College Ave, Ellicott City, MD 21043-5506 | 2009-06-16 |
| 1548452147 | Ariel Antonio Vitali Jr. | Psychiatry & Neurology | 4100 College Ave, Ellicott City, MD 21043 | 2007-08-16 |
| 1184836462 | Deoroop Gurprasad | Psychiatry & Neurology | 4100 College Ave, Ellicott City, MD 21043-5506 | 2007-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982242764 | Joyce Melinda Kelly | Social Worker | 8181 Main Street, 2nd Floor, Ellicott City, MD 21043 | 2019-12-12 |
| 1437703972 | Capitol Health Care, LLC | Speech-Language Pathologist | 4115 Sears House Court, Ellicott City, MD 21043 | 2019-08-01 |
| 1851857429 | Carol Ann Mckissick | Counselor | 2850 N. Ridge Rd. Suite 208a, Santoro Psychological Services, Ellicott City, MD 21043 | 2019-02-19 |
| 1659877017 | Tender Touch Healthcare Services LLC | In Home Supportive Care | 8960 Town and Country Blvd, Apt F, Ellicott, MD 21043 | 2018-04-04 |
| 1912426099 | Hf & Associates, LLC | Community/Behavioral Health | 3565 C2 Ellicott Mills Drive, Suite 202, Ellicott City, MD 21043 | 2017-09-11 |
| 1134666779 | Stephanie Jean | Behavioral Analyst | 8762 Town and Country Blvd, Ellicott City, MD 21043 | 2017-01-20 |
| 1124574744 | I Can't We Can Counseling Center | Preferred Provider Organization | 7060 O(akland Mills Rd, Columbia, MD 21043 | 2016-09-01 |
| 1598139925 | Jun Woo Lee | Chiropractor | 8492 Baltimore National Pike Suite 105, Ellicott City, MD 21043 | 2015-11-23 |
| 1518338953 | Byron Lam | Chiropractor | 2850 N Ridge Rd Ste 107a, Ellicott City, MD 21043 | 2015-10-12 |
| 1942682174 | Jea Sub Song | Chiropractor | 3460 Ellicott Center Dr Ste 102, Ellicott City, MD 21043 | 2015-06-24 |
| Find all providers in zip 21043 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760011340 | Abitha Priya Perumal | Nurse Practitioner | 2767 Saint Johns Ln, Ellicott City, MD 21042-2552 | 2020-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821697533 | Brighter Days Recovery Center | Nurse Practitioner | 2439 E Lafayette Ave, Baltimore, MD 21213-2562 | 2020-10-23 |
| 1033718762 | White Plains Primary Care | Nurse Practitioner | 50 Post Office Rd Ste 304, Waldorf, MD 20602-3704 | 2020-10-23 |
| 1245839653 | Itoro Abatai | Nurse Practitioner | 9620 Maxwell Rd, Middle River, MD 21220-3792 | 2020-10-19 |
| 1992304372 | Catherine Koskei | Nurse Practitioner | 2295 Lowell Ridge Rd Apt B, Parkville, MD 21234-2370 | 2020-10-18 |
| 1194323857 | Meliora Davies | Nurse Practitioner | 206 Settlers Way, Upper Marlboro, MD 20774-5770 | 2020-10-14 |
| 1932707171 | David Mwangi | Nurse Practitioner | 27 Blue Spire Cir, Middle River, MD 21220-1743 | 2020-10-10 |
| 1750989042 | Osereme Nora Agboifo | Nurse Practitioner | 200 Ejoppa Rd Suite 106, Townson, MD 21286 | 2020-10-09 |
| 1639776446 | Serenity Heart Healthcare, LLC | Nurse Practitioner | 6755 Business Pkwy Ste 304, Elkridge, MD 21075-6740 | 2020-10-05 |
| 1689281529 | Premier Psychiatry, LLC | Nurse Practitioner | 10601 Virginia Ave, Cockeysville, MD 21030-2315 | 2020-09-24 |
| 1407462559 | Mem Scepter Home & Behavioral | Nurse Practitioner | 14104 Dawn Whistle Way, Bowie, MD 20721-1304 | 2020-09-23 |
| Find all providers with the same taxonomy | ||||
| City | ELLICOTT CITY |
| Zip Code | 21043 |
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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.