DR. VELMA SUSAN BRADFORD (NPI# 1629070636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629070636 |
| Entity Type | Individual |
| Full Name | DR. VELMA SUSAN BRADFORD |
| Other Name | SUSAN BRADFORD LOWERY |
| Credential | M.D. |
| Practice Address |
2275 S Eagle Rd Ste 120 Meridian ID 83642-2620 |
| Mailing Address |
3653 N. Locust Grove Road Meridian ID 83646 |
| Practice Telephone | 2085142520 |
| Practice Fax Number | 2083752217 |
| Mailing Telephone | 2083385437 |
| Mailing Fax Number | 2089399811 |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2019-02-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 173000000X | Legal Medicine | M7541 | ID | Other Service Providers |
| Y | 208000000X | Pediatrics | M-7541 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1629070636 | 05 | |
| ID | 805219300 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 121 E Fort St, Boise, ID 837126322 | 2085142525 | 2083752217 |
| Street Address |
2275 S EAGLE RD STE 120 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-2620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710525829 | The Family Medicine Residency of Idaho, Inc. | Pharmacy | 2275 S Eagle Rd Ste 120, Meridian, ID 83642-2620 | 2019-12-19 |
| 1952769499 | Megan A Wolf | Counselor | 2275 S Eagle Rd Ste 120, Meridian, ID 83642 | 2016-01-28 |
| 1871904789 | Danielle Lynn Davies | Family Medicine | 2275 S Eagle Rd Ste 120, Meridian, ID 83642-2620 | 2014-05-13 |
| 1659782829 | Kelsey Janel Wertzler | Family Medicine | 2275 S Eagle Rd Ste 120, Meridian, ID 83642-2620 | 2014-05-09 |
| 1750509725 | Vincent Joseph Serio IIi | Family Medicine | 2275 S Eagle Rd Ste 120, Meridian, ID 83642-2620 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801216940 | Seth Branahl | Pediatrics | 520 S Eagle Rd Ste 2209, Meridian, ID 83642-6354 | 2014-04-16 |
| 1972872950 | John Dubard Mceachin | Pediatrics | 4820 Country Club Dr, Meridian, MS 39305-1839 | 2011-12-21 |
| 1841598273 | Anderson Physician Alliance, Inc. | Pediatrics | 2514 67th Avenue Loop Ste 112, Meridian, MS 39307-7260 | 2011-03-09 |
| 1033435896 | Lisa S Labor | Pediatrics | 1620 S. Celebration, Meridian, ID 83642 | 2010-04-19 |
| 1770729063 | Alliance Medical Group, LLC | Pediatrics | 3280 E. Lanark Drive, Meridian, ID 83642 | 2008-12-17 |
| 1356504872 | Robert Ira Eubanks | Pediatrics | 1523 22nd Ave Ste B, Meridian, MS 39301-4016 | 2008-07-03 |
| 1154535375 | Mary Alice Schaefer | Pediatrics | 7961 Van Zyverden Rd, Meridian, MS 39305-9124 | 2007-05-09 |
| 1063557163 | Eastgate Peds Care | Pediatrics | 2203 Highway 39 N Ste B, Meridian, MS 39301-2609 | 2007-02-20 |
| 1477501880 | Elsa J. Lee | Pediatrics | 1620 S Celebration Ave, Meridian, ID 83642-2779 | 2006-05-05 |
| 1356306740 | Kimberly D Ferguison | Pediatrics | 3277 E Louise Dr Ste 200, Meridian, ID 83642-9351 | 2006-04-19 |
| Find all providers in MERIDIAN | ||||
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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.