CHAUNCEY BRADFORD (NPI# 1508474917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508474917 |
| Entity Type | Individual |
| Full Name | CHAUNCEY BRADFORD |
| Practice Address |
1616 E Main St Ste 207a-1 Mesa AZ 85203-9071 |
| Practice Telephone | 4804779199 |
| Practice Fax Number | 4804779199 |
| Mailing Telephone | 4804779199 |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2020-07-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | AZ | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 503836 | 05 |
| Street Address |
1616 E MAIN ST STE 207A-1 |
| City | MESA |
| State | AZ |
| Zip Code | 85203-9071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679181457 | Justin David Lee Harvey | Peer Specialist | 1616 E Main St Ste 207a-1, Mesa, AZ 85203-9071 | 2020-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073147195 | Armada Group-az, LLC | Residential Treatment Facility, Physical Disabilities | 1612 E. Knoll Circle, Mesa, AZ 85203 | 2020-02-27 |
| 1598251142 | Jonathan Harris | Physician Assistant | 220 N Stapley Dr Ste B, Mesa, AZ 85203 | 2018-07-06 |
| 1316437502 | Arizona's Children Association | Clinic/Center | 1345 E Main St Ste 104, Mesa, AZ 85203 | 2018-05-14 |
| 1922506856 | Hernimarc Durable Medical Equipment | Durable Medical Equipment & Medical Supplies | 1350 E Mckellips Rd Ste 3, Mesa, AZ 85203 | 2018-01-25 |
| 1912411638 | Charles Rudy Wermuth | Surgery | Charles R. Mermuth M.d., 2615 N Barkley, Mesa, AZ 85203 | 2017-11-17 |
| 1841714631 | J. Susanne Davis | Chiropractor | 62 N. Stapley Drive, Mesa, AZ 85203 | 2017-08-02 |
| 1699295329 | Preferred Homecare Infusion LLC | Home Health | 1134 E University Dr Ste 110, Mesa, AZ 85203 | 2017-06-23 |
| 1619407442 | Modern Vascular Institute LLC | Internal Medicine | 535 E Mckellips Rd Ste 115, Mesa, AZ 85203 | 2017-06-14 |
| 1962951632 | Julia A. Gunthner | Counselor | 1528 E. Gary St., Mesa, AZ 85203 | 2016-09-23 |
| 1689121105 | Justine Muntz | Occupational Therapy Assistant | 1304 E. Harvest, Mesa, AZ 85203 | 2016-09-01 |
| Find all providers in zip 85203 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679181457 | Justin David Lee Harvey | Peer Specialist | 1616 E Main St Ste 207a-1, Mesa, AZ 85203-9071 | 2020-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689295636 | Native Music Coalition | Peer Specialist | 4814 S Warren Ave, Tucson, AZ 85714-1749 | 2020-04-30 |
| 1063031532 | Grace Irene Tang | Peer Specialist | 3023 N Calle Castellon, Tucson, AZ 85745-9512 | 2020-04-14 |
| 1407493687 | Vincent Merced Flores | Peer Specialist | 1706 E Calle Salamanca, Tucson, AZ 85714-1729 | 2019-12-05 |
| 1043737497 | Penny Pulz Golf LLC | Peer Specialist | 10315 W Wininger Cir Ste B, Sun City, AZ 85351-4758 | 2017-08-26 |
| 1275917379 | Diedra Y Kinne | Peer Specialist | 240 West Jensen St., Fredonia, AZ 86022-0491 | 2015-07-17 |
| 1861884157 | Valena F Eisenhart | Peer Specialist | 1745 N Kadota Ave, Casa Grande, AZ 85122-2131 | 2015-02-24 |
| 1578953477 | Vincent Nicasio Jr. | Peer Specialist | 471 N Marshall Loop Rd, Somerton, AZ 85350-6216 | 2015-01-29 |
| 1235737156 | Timothy Chakos-kender | Peer Specialist | 4343 N 16th St, Phoenix, AZ 85016-5338 | 2020-10-13 |
| 1518565696 | Aaron R Fry | Peer Specialist | 4343 N 16th St, Phoenix, AZ 85016-5338 | 2020-10-12 |
| 1851945166 | Jesse Anthony Ruelas | Peer Specialist | 1500 E Thomas Rd Ste 106, Phoenix, AZ 85014-5748 | 2019-07-25 |
| Find all providers with the same taxonomy | ||||
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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.