KEVIN BRADLEY (NPI# 1306455522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306455522 |
| Entity Type | Individual |
| Full Name | KEVIN BRADLEY |
| Credential | SOIDC |
| Practice Address |
903 13th St Virginia Beach VA 23451-4476 |
| Practice Telephone | 9104655610 |
| Mailing Telephone | 9104655610 |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2020-07-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NAVY | 1367445790 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184192981 | Kevin Bradley | Social Worker | 12408 Alexander Cornell Dr, Fairfax, VA 22033-2414 | 2018-11-09 |
| 1578867552 | Kevin Lyle Bradley | Massage Therapist | 2429 Manatee Ave E Unit 3, Bradenton, FL 34208-2407 | 2011-01-05 |
| 1821317454 | Kevin Jamal Bradley | Counselor | 509 S Flower St Apt 2, Inglewood, CA 90301-2881 | 2010-05-21 |
| 1609971241 | Kevin G. Bradley | Chiropractor | 640 Alexander Dr Ste 107, Eufaula, OK 74432-4013 | 2006-09-14 |
| 1447770870 | Kevin Alan Bradley | Licensed Practical Nurse | 180 Grafton Ln, Berryville, VA 22611-2576 | 2017-06-27 |
| 1922551266 | Kevin Bradley | Military Health Care Provider | 1 Wahoo Ave, Groton, CT 06349 | 2016-08-03 |
| 1447634142 | Kevin Bradley | Adult Companion | 847 Ne 19th Ave, Portland, OR 97232-2684 | 2015-07-13 |
| 1477996262 | Kevin K. Bradley | Anesthesiology | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2013-04-10 |
| 1093880486 | Kevin Grant Bradley | Emergency Medicine | 5149 N 9th Ave, Suite 120, Pensacola, FL 32504-8756 | 2006-11-21 |
| 1588683809 | Kevin Bradley | Social Worker | 977 Lakeview Pkwy, Suite 180, Vernon Hills, IL 60061-1400 | 2006-07-18 |
| Street Address |
903 13TH ST |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23451-4476 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316547268 | Brynn Arica Carey | Speech-Language Pathologist | Laskin Road Annex, 1413 Laskin Road, Virginia Beach, VA 23451 | 2020-10-29 |
| 1851864094 | Erica Genevieve Johns | Counselor | 253 C Street, Camp Pendleton, Virginia Beach, VA 23451 | 2019-01-10 |
| 1407327729 | Crystal Michelle Larios | Physical Therapy Assistant | Westminster Canterbury, Virginia Beach, VA 23451 | 2018-12-14 |
| 1215423322 | Ketan Patel | Dentist | 395 Norfolk Ave, Virginia Beach, VA 23451 | 2018-07-02 |
| 1356844427 | Kristina Maria Matthews | Nurse's Aide | 1206 Laskin Road, Suite 140-g, Virginia Beach, VA 23451 | 2018-03-14 |
| 1437652823 | Beach Medical Suppliers LLC | Durable Medical Equipment & Medical Supplies | 2256 W. Great Neck Rd, Virginia Beach, VA 23451 | 2018-03-13 |
| 1740782291 | Sherree Weeks | Speech-Language Pathologist | 1413 Laskin Rd., Va. Beach, VA 23451 | 2018-03-01 |
| 1649709007 | Christine Herslow | Registered Nurse | 2200 Elder Road, Virginia Beach, VA 23451 | 2017-06-08 |
| 1538611066 | Wal-mart Stores East, Lp | Technician/Technologist | 546 First Colonial Road, Virginia Beach, VA 23451 | 2016-11-01 |
| 1306182795 | John Leroy Stacy Jr. | Counselor | 409 Birdneck Cir, Virginia Beach, VA 23451 | 2012-12-12 |
| Find all providers in zip 23451 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900088 | Seth Walter | Military Health Care Provider | 1825 Olympic Dr, Virginia Beach, VA 23453-3720 | 2020-07-23 |
| 1912545534 | Ashton Neal Burnett | Military Health Care Provider | 1875 Cove Rd Bldg 3806, Virginia Beach, VA 23459-8911 | 2019-12-13 |
| 1578056743 | Elis Bojaxhi | Military Health Care Provider | 3044 Ashlawn Ter, Virginia Beach, VA 23452-6508 | 2018-06-12 |
| 1497298616 | Mario Zavala | Military Health Care Provider | 408 N Amsterdam Ct, Virginia Beach, VA 23454-4213 | 2016-11-19 |
| 1568904738 | Pierce Cogburn | Military Health Care Provider | 3985 Old Forge Rd, Virginia Beach, VA 23452-2173 | 2016-11-04 |
| 1851841449 | John Douglas Moore | Military Health Care Provider | 1004 Hermitage Rd Bldg 1014, Virginia Beach, VA 23459-9100 | 2016-10-07 |
| 1730559618 | Aaron Joseph Cortina | Military Health Care Provider | 2340 Amphibious Dr, Bldg 2012 Suite 125, Virginia Beach, VA 23459-8810 | 2015-10-05 |
| 1427430297 | Daniel Anthony Leonesio | Military Health Care Provider | 1432 Pandoria Ct, Virginia Beach, VA 23455-3738 | 2015-06-29 |
| 1346659570 | Nicholas Charles Edward Rohde | Military Health Care Provider | 4946 Juno Rd, Virginia Beach, VA 23455-2244 | 2014-08-13 |
| 1437587375 | Benny Husinecky IIi | Military Health Care Provider | 221 Mica Ave, Apt 304, Virginia Beach, VA 23462-4579 | 2013-10-30 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23451 |
Please comment or provide details below to improve the information on KEVIN BRADLEY.
| 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.