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RUSSELL BRADLEY MD NPI 1376502013


NPI Information

NPI: 1376502013
Provider Name: RUSSELL BRADLEY, MD
Classification: Emergency Medicine - 207P00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1050 E SOUTH TEMPLE
SALT LAKE CITY, UT
ZIP 84102
Phone: (801) 350-4111
Get Directions

Russell Bradley, MD is an emergency medicine in Salt Lake City, UT. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. Russell Bradley, MD NPI is 1376502013. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1050 E SOUTH TEMPLE
SALT LAKE CITY, UT
ZIP 84102-507
Phone: (801) 350-4111

The NPI 1376502013 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/21/2006 and was last updated on 4/21/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207PE0004XEmergency MedicineEmergency Medical Services360067-1205UTAHNo
2207P00000XEmergency Medicine360067-1205UTAHYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1005568619MEDICARE ID-TYPE UNSPECIFIEDUTAH1050 E SOUTH TEMPLE, SLC
2G22168MEDICARE UPINUTAH
3005786112MEDICARE ID-TYPE UNSPECIFIEDUTAH2055 N MAIN, TOOELE
4D2647MEDICAIDUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.