JON PAUL BRADLEY (NPI# 1578050696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578050696 |
| Entity Type | Individual |
| Full Name | JON PAUL BRADLEY |
| Practice Address |
2200 Fort Roots Dr North Little Rock AR 72114-1709 |
| Mailing Address |
3115 Crawford Loop Conway AR 72034-8122 |
| Practice Telephone | 5012573347 |
| Mailing Telephone | 5014287654 |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2018-04-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
R106690 | AR | Nursing Service Providers |
| Street Address |
2200 FORT ROOTS DR |
| City | NORTH LITTLE ROCK |
| State | AR |
| Zip Code | 72114-1709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750388401 | Ivy V Mcgee | Family Medicine | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2005-07-07 |
| 1477161586 | Kaila Mitchell | Psychologist | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2020-07-15 |
| 1689200040 | Tonie Brenee' Williams | Social Worker | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2020-03-18 |
| 1447899646 | Eugenia Boozer | Clinical Neuropsychologist | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2020-01-06 |
| 1376181263 | Linda Shrader | Technician | 2200 Fort Roots Dr, North Little Rock, AR 72114 | 2019-12-11 |
| 1205470507 | Julie Renee Thyberg | Technician | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2019-10-30 |
| 1588215966 | Venius Vernester Russell | Technician | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2019-09-26 |
| 1538718119 | Mary Kathryn Martin | Technician | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2019-09-06 |
| 1689223596 | Meriline White | Technician | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2019-09-04 |
| 1124677943 | Felicia Clayton | Technician | 2200 Fort Roots Dr, North Little Rock, AR 72114 | 2019-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316432966 | Mid State Counseling and Recovery Service | Clinic/Center | 1920 Main St Ste 229, North Little Rock, AR 72114 | 2018-06-26 |
| 1053826842 | Kelli Lauron Johnson | Nurse Practitioner | 2800 North Willow Street, North Little Rock, AR 72114 | 2017-12-03 |
| 1689117756 | State of Arkansas | Skilled Nursing Facility | 2401 John Ashley Drive, Building #100, North Little Rock, AR 72114 | 2016-11-22 |
| 1366787459 | J Andrew Mccullough | Counselor | 628 W Broadway St Ste 300, North Little Rock, AR 72114 | 2012-11-30 |
| 1598071490 | Roger Elliott Hicks IIi | Counselor | 2200 Fort Roots Dr # 3d, North Little Rock, AR 72114 | 2010-08-30 |
| 1740594456 | Tuyet Thi Van | Dentist | 520 W. Pershing Blvd., North Little Rock, AR 72114 | 2010-08-05 |
| 1467764183 | Jennifer Leigh Nash | Behavioral Analyst | 628 W Broadway St Ste 100, North Little Rock, AR 72114 | 2010-07-10 |
| 1336398544 | Tina A Davie | Registered Nurse | 2200 Foot Roots Drive, Little Rock, AR 72114 | 2008-09-11 |
| 1316125313 | Centers for Youth & Families | Community/Behavioral Health | 200 W. 20th, North Little Rock, AR 72114 | 2008-02-01 |
| 1881878064 | Marie A Graham | Nurse Practitioner | 636 West Broadway St, No Little Rock, AR 72114 | 2007-12-24 |
| Find all providers in zip 72114 | ||||
| Taxonomy Code | 163WP0809X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174617385 | Peggy Susan Morrow | Registered Nurse | 3805 Mccain Park Dr 116, North Little Rock, AR 72116-7813 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992335707 | Candena Marie Fuller | Registered Nurse | 10 Canterbury Cir, Batesville, AR 72501-9185 | 2020-01-21 |
| 1538715180 | Ronald F. Henson | Registered Nurse | 8067 Highway 336 W, Clinton, AR 72031-8438 | 2019-08-09 |
| 1144459355 | Melanie Sterling & Assoc LLC | Registered Nurse | 2796 S 2nd St, Suite E, Cabot, AR 72023-7020 | 2009-07-09 |
| 1902933187 | Carol Ruth Vela | Registered Nurse | 2400 S 48th Street, Springdale, AR 72762 | 2007-02-27 |
| 1477652089 | Tamra Sue Mcgehee | Registered Nurse | 311 Whittington Ave, Hot Springs, AR 71901-3407 | 2006-09-21 |
| 1003843277 | Jo Ann Clay | Registered Nurse | 680 Hogan Ln, Conway, AR 72034-8131 | 2006-06-26 |
| 1033728266 | Cody Burkett | Registered Nurse | 11700 Kanis Rd Ste 2, Little Rock, AR 72211-3794 | 2020-07-23 |
| 1639701022 | Ryan Nikolai Leslie | Registered Nurse | 10025 W Markham St Ste 210, Little Rock, AR 72205-2178 | 2020-02-04 |
| 1851690994 | Roxanne Hunter | Registered Nurse | 1014 Autumn Rd, Suite 4, Little Rock, AR 72211-3704 | 2011-03-15 |
| 1356673909 | Erin Rae Morin | Registered Nurse | 2400 S 48th St, Springdale, AR 72762-6683 | 2010-02-08 |
| Find all providers with the same taxonomy | ||||
| City | NORTH LITTLE ROCK |
| Zip Code | 72114 |
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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.