COLLEEN BRADLEY (NPI# 1255995411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255995411 |
| Entity Type | Individual |
| Full Name | COLLEEN BRADLEY |
| Practice Address |
2611 Forest Dr Columbia SC 29204-2379 |
| Practice Telephone | 8037793263 |
| Mailing Telephone | 4786627061 |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2020-01-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 3360 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336494707 | Colleen Bradley | Counselor | 8 Serpentine Ln, Levittown, NY 11756-3804 | 2012-07-20 |
| 1164995908 | Colleen Elizabeth Bradley | Behavior Technician | 4100 Price Club Blvd, Midlothian, VA 23112-3379 | 2019-01-04 |
| Street Address |
2611 FOREST DR |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29204-2379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982618161 | Trinity Counseling Services LLC | Counselor | 2611 Forest Dr, Suite 206, Columbia, SC 29204-2379 | 2006-07-27 |
| 1700374162 | Physical Rehabilitation Group, LLC | Physical Therapist | 2611 Forest Dr, Columbia, SC 29204-2379 | 2018-05-01 |
| 1033425293 | Journey Forward, LLC | Counselor | 2611 Forest Dr, Suite 129, Columbia, SC 29204-2379 | 2010-08-26 |
| 1912132770 | Encore Supply and Services,inc | Durable Medical Equipment & Medical Supplies | 2611 Forest Dr, Suite 130, Columbia, SC 29204-2379 | 2009-05-22 |
| 1386882017 | Abundant Home Care Solutions LLC | Preferred Provider Organization | 2611 Forest Dr, Suite 206, Columbia, SC 29204-2379 | 2009-02-03 |
| 1245477488 | Calvin Gibbs | Orthotic Fitter | 2611 Forest Dr, Suite 103 Office 116, Columbia, SC 29204-2379 | 2009-01-09 |
| 1336302538 | Journey Forward | Counselor | 2611 Forest Dr, Suite 129, Columbia, SC 29204-2379 | 2008-07-08 |
| 1730201815 | Wanda Nunn | Counselor | 2611 Forest Dr, Suite 129, Columbia, SC 29204 | 2007-04-06 |
| 1538206735 | Jerome Prezzy | Psychologist | 2611 Forest Dr, Suite 114a, Columbia, SC 29204-2379 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992215149 | Ricardo Colon II | Registered Nurse | 3000 Hampton Street, Columbia, SC 29204 | 2017-10-02 |
| 1780113522 | Carla Star Noe | Registered Nurse | Sc Department of Health and Environmental Control, 2100 Bull Street, Collumbia, SC 29204 | 2017-06-06 |
| 1124568514 | Kristy L Thompson | Nurse Practitioner | 1655 Bernardin Ave Ste 240, Columbia, SC 29204 | 2017-03-03 |
| 1982052031 | Harold Eugene Cook Iv | Podiatrist | 1730 St Julian Place, Columbia, SC 29204 | 2016-05-31 |
| 1851748974 | Shaquita Banks | Counselor | 1810 Allen Benedict Ct, A1, Columbia, SC 29204 | 2016-05-18 |
| 1265804835 | Premier Care, LLC | Case Management | 2712 Middleburg Drive, Suite 206, Columbia, SC 29204 | 2015-10-22 |
| 1023492287 | Shamiquia N. Mcpherson | Counselor | 1627 Auburn St., Columbia, SC 29204 | 2015-07-16 |
| 1285028449 | The Columbia Free Medical Clinic, Inc. | Clinic/Center | 1875 Harden Street, Columbia, SC 29204 | 2015-03-26 |
| 1629473459 | Leslie Wilson | Counselor | 2323 Lady Street, Columbia, SC 29204 | 2014-10-22 |
| 1053728683 | Candyce Sutton | Social Worker | 1135 Carter Street, Columbia, SC 29204 | 2014-07-15 |
| Find all providers in zip 29204 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619500691 | Ivanka M Mora | Physician Assistant | 5910 Watch Chain Way Apt 603, Columbia, MD 21044-3875 | 2020-02-18 |
| 1316579287 | Christina Verzi | Physician Assistant | 5681 Columbia Rd Apt 301, Columbia, MD 21044-1960 | 2020-02-10 |
| 1225668064 | Steven Ebers | Physician Assistant | 1201 International Dr, Columbia, MO 65202-1612 | 2020-01-21 |
| 1780228197 | Jeremy M Barth | Physician Assistant | 5886 Morningbird Ln, Columbia, MD 21045-3508 | 2019-10-30 |
| 1730749920 | Ann Marie Schlafly | Physician Assistant | 1 Hospital Drive, Mc 413, Columbia, MO 65212-0001 | 2019-06-19 |
| 1619532363 | Casey Burner Skinner | Physician Assistant | 2126 Tugaloo Ave, Columbia, SC 29205-3330 | 2019-05-08 |
| 1205491040 | Meghan Catherine Monk | Physician Assistant | 229 Route 87, Columbia, CT 06237-1050 | 2019-05-07 |
| 1124594999 | Candace Rachel Skulkety | Physician Assistant | 612 Whaley St Apt 348, Columbia, SC 29201-6329 | 2018-10-19 |
| 1508346396 | Hannah Marie Dewes | Physician Assistant | 3 Medical Park Rd #310, Columbia, SC 29203 | 2018-08-21 |
| 1295236438 | Helen Mckinney | Physician Assistant | 234 Castlebury Dr, Columbia, SC 29229-7566 | 2018-02-22 |
| Find all providers in COLUMBIA | ||||
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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.