BRADLEY MARTIN (NPI# 1114536737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114536737 |
| Entity Type | Individual |
| Full Name | BRADLEY MARTIN |
| Credential | PMHNP |
| Practice Address |
31 M St Apt 110 Salt Lake City UT 84103-3846 |
| Practice Telephone | 4357996962 |
| Mailing Telephone | 4357996962 |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2020-08-03 |
| 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 |
6846879-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467006916 | Bradley Martin | Student in an Organized Health Care Education/Training Program | 5189 Pine Abbey Drive South, West Palm Beach, FL 33415 | 2019-08-01 |
| 1124398631 | Bradley A Martin | Speech-Language Pathologist | 509 Hummingbird Cv, Jonesboro, AR 72404-8516 | 2012-01-01 |
| 1851693659 | Bradley Eugene Martin | Contractor | 8414 Meadow Green Way, Gaithersburg, MD 20877-3741 | 2010-11-30 |
| 1841249489 | Bradley Martin | Physician Assistant | 1014 Biglane Drive, Brookhaven, MS 39601 | 2006-05-10 |
| 1689274664 | Bradley Martin | Dental Hygienist | 2630 Central Ave, Eielson Afb, AK 99702-2301 | 2020-10-28 |
| 1639788086 | Bradley Martin | Counselor | 11027 Burbank Blvd, North Hollywood, CA 91601-2431 | 2020-07-30 |
| 1144729153 | Bradley Neal Martin | Social Worker | 3809 Rosewood Dr, Columbia, SC 29205-3533 | 2018-02-05 |
| 1518481522 | Bradley Martin | Physical Therapist | 5535 S Williamson Blvd Ste 774, Port Orange, FL 32128-8321 | 2017-08-01 |
| 1376078212 | Bradley Nelson Martin | Student in an Organized Health Care Education/Training Program | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2017-04-28 |
| 1992163638 | Bradley Martin | Counselor | 1 Veterans Dr, Minneapolis, MN 55417-2309 | 2016-02-09 |
| Street Address |
31 M ST APT 110 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84103-3846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932509213 | Paul David Rauch | Specialist/Technologist | 701 De Soto Street, Salt Lake City, UT 84103 | 2014-08-24 |
| 1073866695 | University Neuropsychiatric Institute | Community Based Residential Treatment Facility, Mental Illness | 252 South 500 East, Salt Lake City, UT 84103 | 2012-10-19 |
| 1114285558 | Christopher John Murphy | Student in an Organized Health Care Education/Training Program | 585 1st Ave, Salt Lake City, UT 84103 | 2012-04-23 |
| 1447573266 | Peter Louis Kapelke | Specialist | Fairfax Rd. @ Virginia St., Shriners Hospital Salt Lake City, Salt Lake City, UT 84103 | 2010-03-08 |
| 1578763389 | Susana Auhangamea Kinikini | Nurse Practitioner | Fairfax @ Virginia Street, Salt Lake City, UT 84103 | 2007-07-19 |
| 1609082320 | Cynthia N Shumway | Social Worker | 580 10th Avenue, Salt Lake City, UT 84103 | 2007-05-16 |
| 1811010655 | Kent Walker Farnsworth | Obstetrics & Gynecology | 1509 Federal Heights Drive, Salt Lake City, UT 84103 | 2007-04-09 |
| 1912082421 | Eloise Agnes Maughan | Nurse Practitioner | 324 8th Ave, Lds Hospital, Salt Lake City, UT 84103 | 2006-10-25 |
| 1407968464 | Kit D Smith | Anesthesiology | 359 - 8th Avenue, Asc, Salt Lake City, UT 84103 | 2006-08-31 |
| 1396854113 | Lisa H Carter | Physical Therapist | 1285 East Fairfax Road, Salt Lake City, UT 84103 | 2006-08-29 |
| Find all providers in zip 84103 | ||||
| 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 |
|---|---|---|---|---|
| 1245877448 | Carla Lucile Applegate-anderson | Nurse Practitioner | 2666 South 2000 East, Suite 101, Salt Lake City, UT 84109 | 2019-12-06 |
| 1720433196 | Lillian Farris | Nurse Practitioner | 2180 E 4500 S Ste 125, Salt Lake City, UT 84117-4021 | 2016-05-04 |
| 1164816922 | Brittany Talbot | Nurse Practitioner | Salt Lake City Vamc, 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2015-03-19 |
| 1376959023 | Charleen Angell Aprn, Pllc | Nurse Practitioner | 145 S 400 E, Salt Lake City, UT 84111-2104 | 2014-07-02 |
| 1619390218 | Darin Ashton Principe | Nurse Practitioner | 159 W Broadway Ste 200, Salt Lake City, UT 84101-1923 | 2014-02-03 |
| 1083052963 | Christina Elizabeth Burton | Nurse Practitioner | 1008 S 1100 E, Apt 6, Salt Lake City, UT 84105 | 2013-06-12 |
| 1124237011 | Maria Christina Paegle | Nurse Practitioner | 4659 Brookwood Dr, Salt Lake City, UT 84117-4909 | 2007-05-21 |
| 1558430389 | Grace Forsythe Phd Inc | Nurse Practitioner | 2046 Murray Holladay Rd, 103, Salt Lake City, UT 84117-5125 | 2006-11-07 |
| 1639279466 | Joann M Rolando | Nurse Practitioner | George E Wahlen Department of Veterans Affairs, Medical Center Va, Salt Lake City, UT 84148-0001 | 2006-09-22 |
| 1457380818 | Alana Jacobs | Nurse Practitioner | 778 Ute Cir, Salt Lake City, UT 84107-5225 | 2006-06-30 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84103 |
Please comment or provide details below to improve the information on BRADLEY MARTIN.
| 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.