EVAN DEREK BRADNER MD
NPI 1073216305
Student in an Organized Health Care Education/Training Program in Charlottesville, VA

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 24, 2023PECOS Enrolled

1215 LEE ST # 800710, CHARLOTTESVILLE, VA 22908(434) 982-0629(434) 982-0019 Get Directions Write a Review

NPPES record last updated: March 24, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Evan Derek Bradner Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVAN DEREK BRADNER MD (NPI 1073216305) is an individual student in an organized health care education/training program in Charlottesville, Virginia and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073216305

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameEVAN DEREK BRADNERCredential: MD

Location Address1215 LEE ST # 800710Charlottesville, VA 22908-0816

Mailing Address1215 Lee St # 800710Charlottesville, VA 22908-0816 · (434) 982-0629 · Fax (434) 982-0019

Phone(434) 982-0629

Fax(434) 982-0019

Sole ProprietorNo

Enumeration DateMarch 24, 2023

NPPES CertifiedMarch 24, 2023

✔ NPI 1073216305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1215 LEE ST # 800710, Charlottesville, VA 22908

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Evan Derek Bradner Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.