RUSSELL D BRADFORD (NPI# 1316093446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316093446 |
| Entity Type | Individual |
| Full Name | RUSSELL D BRADFORD |
| Credential | M.D. |
| Practice Address |
1034 N 500 W Provo UT 84604-3380 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 8014916482 |
| Mailing Telephone | 8014916482 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2012-06-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0208X |
Pediatrics Specialization: Pediatric Infectious Diseases |
23648 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 009912727 | 05 | |
| AL | BCBS | 051545309 | 01 |
| AL | 009919575 | 05 | |
| AL | 009919585 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881063709 | Russell Bradford | Private Vehicle | 75 Locust Grv, Hazlet, NJ 07730-4144 | 2015-09-21 |
| Street Address |
1034 N 500 W |
| City | PROVO |
| State | UT |
| Zip Code | 84604-3380 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780671453 | Marc Sune Robins | Family Medicine | 1034 N 500 W, Provo, UT 84604-3380 | 2005-09-28 |
| 1417562885 | Mckenzie Hamilton | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2020-09-13 |
| 1235741042 | Kristi Kay Anderson | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2020-08-21 |
| 1255968681 | Tiffani Petersen | Registered Nurse | 1034 N 500 W, Provo, UT 84604-3380 | 2020-03-25 |
| 1477188811 | Jodi Benson | Dietitian, Registered | 1034 N 500 W, Provo, UT 84604-3380 | 2020-03-05 |
| 1649815879 | Jessica Ricaurte | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2019-11-12 |
| 1174167795 | Courtney Danielle Akina | Speech-Language Pathologist | 1034 N 500 W, Provo, UT 84604-3337 | 2019-11-06 |
| 1396393609 | Camille Stanley | Speech-Language Pathologist | 1034 N 500 W, Provo, UT 84604-3380 | 2019-08-29 |
| 1386292076 | Rebecca Harris | Occupational Therapist | 1034 N 500 W, Provo, UT 84604-3380 | 2019-08-27 |
| 1770139289 | Cameron Lee Tingey | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2019-08-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 2080P0208X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Infectious Diseases |
| A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285098855 | University of Utah Pediatric Services | Pediatrics | 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 | 2016-04-11 |
| 1487970554 | Adam L Hersh | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2010-04-14 |
| 1629157193 | Kwabena Krow Ampofo | Pediatrics | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2006-11-03 |
| 1851481444 | Carrie Lynn Byington | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2006-10-13 |
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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.