DR. J DOUGLAS BRADLEY (NPI# 1932249588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932249588 |
| Entity Type | Individual |
| Full Name | DR. J DOUGLAS BRADLEY |
| Credential | M.D. |
| Practice Address |
4117 N Elizabeth St Pueblo CO 81008-2009 |
| Mailing Address |
3190 Breckenridge Dr W Colorado Springs CO 80906-4539 |
| Practice Telephone | 7195450788 |
| Practice Fax Number | 7195450787 |
| Mailing Telephone | 7195405655 |
| Mailing Fax Number | 7195405655 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 35663 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 01356633 | 05 |
| Street Address |
4117 N ELIZABETH ST |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-2009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770107179 | Derrick Christopher Penticuff | Physical Therapist | 4117 N Elizabeth St, Pueblo, CO 81008-2009 | 2020-06-01 |
| 1760025571 | Occuaptional Health Centers of The Southwest, P.a. | Clinic/Center | 4117 N Elizabeth St, Pueblo, CO 81008-2009 | 2019-10-24 |
| 1053954867 | American Currenct Care P.a. | Clinic/Center | 4117 N Elizabeth St, Pueblo, CO 81008-2009 | 2019-10-24 |
| 1376070433 | Loralie Ramos | Physical Therapy Assistant | 4117 N Elizabeth St, Pueblo, CO 81008-2009 | 2017-05-18 |
| 1386775781 | Traumatic Brain Injury of Southern Colorado, PC | Clinical Neuropsychologist | 4117 N Elizabeth St, Pueblo, CO 81008-2009 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
| Find all providers in zip 81008 | ||||
| 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 |
|---|---|---|---|---|
| 1356992606 | Kristie Lamotta | Family Medicine | 1600 N Grand Ave Ste 350, Pueblo, CO 81003-2729 | 2019-09-26 |
| 1558898569 | Alexandra R B King | Family Medicine | Southern Colorado Family Medicine, 902 Lakeview Avenue, Pueblo, CO 81004 | 2017-05-22 |
| 1134484660 | Aparna Seetharama | Family Medicine | 1600 N. Grand Ave, Ste 260, Pueblo, CO 81003-2729 | 2012-07-11 |
| 1710275037 | Catholic Health Initiatives Colorado | Family Medicine | 916 Indiana Ave., Suite 120, Pueblo, CO 81004 | 2011-07-20 |
| 1124336169 | Timothy J Cawlfield, Md, Pllc | Family Medicine | 41 Montebello Rd Ste 210, Pueblo, CO 81001-1379 | 2010-09-23 |
| 1639308828 | Emma Iovane Stout | Family Medicine | 115 E. Riverwalk, Suite 200, Pueblo, CO 81003-2246 | 2009-07-08 |
| 1750510145 | Wendy Alejandra Girard | Family Medicine | 1925 East Orman Avenue, Suite A109, Pueblo, CO 81004 | 2009-07-07 |
| 1881839694 | Bryan A Hynes | Family Medicine | 415 N Grand Ave, Pueblo, CO 81003-3111 | 2008-12-08 |
| 1093988917 | Louise Mcdade | Family Medicine | 8 Carlile Pl, Pueblo, CO 81004-1213 | 2008-04-11 |
| 1891914693 | Prairie Medical Clinic Pllc | Family Medicine | 1726 S Prairie Ave, Pueblo, CO 81005-2253 | 2007-04-24 |
| Find all providers in PUEBLO | ||||
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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.