BRADLEY CENTER PC (NPI# 1881978047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881978047 |
| Entity Type | Organization |
| Organization Name | BRADLEY CENTER PC |
| Other Organization Name | EPIC FUNCTIONAL MEDICINE CENTER |
| Practice Address |
1527 S Gilbert St Iowa City IA 52240-4367 |
| Practice Telephone | 3194660026 |
| Mailing Telephone | 3194660026 |
| Mailing Fax Number | 3195408354 |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2019-08-08 |
| Authorized Official Name | DR. JASON T BRADLEY (DIRECTOR) |
| Authorized Official Telephone | 3194660026 |
| Authorized Official Credential | D.C., N.D., M.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| EPIC Functional Medicine Center | Doing Business As Name - Organization |
| Washington Street Wellness Center | Doing Business As Name - Organization |
| Street Address |
1527 S GILBERT ST |
| City | IOWA CITY |
| State | IA |
| Zip Code | 52240-4367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215408703 | Huan-chung Scott Liu | Psychologist | 332 S Linn St Ste 14, Iowa City, IA 52240 | 2018-12-10 |
| 1124531579 | Amber Marie Wong | Counselor | 47 High Circle Drive, Iowa City, IA 52240 | 2017-11-08 |
| 1356852321 | Spencer Joseph Bohr | Specialist/Technologist | 314 S Governor St, Iowa City, IA 52240 | 2017-10-18 |
| 1992215651 | Kezia Jade Digioia | Student in an Organized Health Care Education/Training Program | 505 East Burlington St, Apt 7b, Iowa City, IA 52240 | 2017-10-09 |
| 1457879694 | Teleigha Teilon Lourell Starks | Specialist/Technologist | 629 South Johnson, 3, Iowa City, IA 52240 | 2017-09-08 |
| 1003213448 | National Seating & Mobility, Inc | Durable Medical Equipment & Medical Supplies | 2415 Heinz Rd Ste 1, Iowa City, IA 52240 | 2014-12-01 |
| 1750701439 | County of Johnson | Public Health or Welfare | 855 S Dubuque, Suite 217, Iowa City, IA 52240 | 2014-04-22 |
| 1083045892 | Julie Louise Gallagher | Dietitian, Registered | 1720 Waterfront Drive, Iowa City, IA 52240 | 2013-12-04 |
| 1619314515 | Jade A Baxley | Physical Therapist | 1130 Scott Blvd., Ste. 1, Iowa City, IA 52240 | 2013-05-31 |
| 1629316062 | Shelter House Community Shelter and Transition Services | Community/Behavioral Health | 429 Southgate Ave, Iowa City, IA 52240 | 2013-01-18 |
| Find all providers in zip 52240 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972162519 | Stephanie Anne Pickthorn | Family Medicine | 200 Hawkins Dr Dept Family, Iowa City, IA 52242-1009 | 2019-06-07 |
| 1326527284 | Ramy Salib | Family Medicine | 1000 Oakcrest St, Iowa City, IA 52246-5194 | 2018-08-11 |
| 1932685013 | Christian Ann Mann | Family Medicine | 826 Basswood Ln, Iowa City, IA 52246-5810 | 2018-07-12 |
| 1255760260 | Mintesinot Fitamo | Family Medicine | 825 Oakcrest St Apt 6, Iowa City, IA 52246-3421 | 2013-11-11 |
| 1548526189 | State University of Iowa | Family Medicine | 767 Mormon Trek Blvd, Iowa City, IA 52246-1812 | 2012-04-09 |
| 1336410471 | Catherine Dehaven Swanson | Family Medicine | 1717 Winston Dr, Iowa City, IA 52245-6047 | 2012-01-20 |
| 1205159688 | Mei Shi | Family Medicine | 1067 Ryan Ct, Iowa City, IA 52246-2847 | 2010-03-12 |
| 1013241850 | State University of Iowa | Family Medicine | 1632 Sycamore St, Iowa City, IA 52240-6044 | 2009-09-28 |
| 1972720274 | Cecilia M Redmond-norris | Family Medicine | 2440 Towncrest Dr, Iowa City, IA 52240-6622 | 2007-04-19 |
| 1336219112 | Michael Lee Burns | Family Medicine | 1040 William, Iowa City, IA 52240-6633 | 2006-11-08 |
| Find all providers in IOWA CITY | ||||
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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.