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MS. NANCY C BRADDOCK PA-C NPI 1437275252


NPI Information

NPI: 1437275252
Provider Name: MS. NANCY C BRADDOCK, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: GASTRO HEALTH, LLC

PECOS Registration: Yes

Address:
311 W LINCOLN ST
STE 201
BELLEVILLE, IL
ZIP 62220
Phone: (618) 222-3200
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MS. Nancy C Braddock, PA-C is a medical physician assistant in Belleville, IL with 22 years of experience. MS. Nancy C Braddock, PA-C NPI is 1437275252. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

311 W LINCOLN ST
STE 201
BELLEVILLE, IL
ZIP 62220-902
Phone: (618) 222-3200
Fax: (618) 222-3203

The NPI 1437275252 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 3/22/2007 and was last updated on 9/12/2018.


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
1363AM0700XPhysician AssistantMedical2011035522MISSOURINo
2363AM0700XPhysician AssistantMedical085002020ILLINOISYes

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.