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BRADLEY MICHAEL WITHERELL
NPI 1487161816
Military Health Care Provider - Independent Duty Corpsman in Jacksonville, FL

Active since January 08, 2018
2104 MASSEY AVE BUILDING 2104, JACKSONVILLE, FL 32228(904) 270-4303 Get Directions Write a Review

NPPES record last updated: April 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bradley Michael Witherell NPPES

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

BRADLEY MICHAEL WITHERELL (NPI 1487161816) is an individual independent duty corpsman provider in Jacksonville, Florida and active in the NPI registry since January 2018.

NPPES Registry Identity

NPI1487161816
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameBRADLEY MICHAEL WITHERELL
Location Address2104 MASSEY AVE BUILDING 2104Jacksonville, FL 32228-0148
Mailing Address2104 Massey Ave Building 2104Jacksonville, FL 32228-0148
Phone(904) 270-4303
Sole ProprietorYes
Enumeration DateJanuary 8, 2018
Last NPPES UpdateApril 15, 2025
NPPES CertifiedApril 9, 2025
✔ NPI 1487161816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
Definition
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
2104 MASSEY AVE BUILDING 2104, Jacksonville, FL 32228
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALBERTO KRIS CIPOLLONE IDC
Military Health Care Provider (Independent Duty Corpsman)
2104 MASSEY AVE BUILDING 2104
JACKSONVILLE, FL 32228
Duval County (904) 270-4386

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bradley Witherell's NPI number?

The NPI number for Bradley Witherell is 1487161816. It was assigned to this individual provider in the NPPES registry on January 8, 2018.

Where is Bradley Witherell located?

Bradley Witherell practices at 2104 Massey Ave Building 2104, Jacksonville, FL 32228. The listed phone number is (904) 270-4303.

What is Bradley Witherell's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Bradley Witherell was last updated on April 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.