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KELLIE BRADFORD MD
NPI 1538726161
Student in an Organized Health Care Education/Training Program in Canton, OH

Active since May 20, 2019PECOS Enrolled
2600 SIXTH ST SW, CANTON, OH 44710(330) 363-6326 Get Directions Write a Review

NPPES record last updated: February 6, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Feb 6, 2024, May 20, 2019 (2 updates tracked since 2019).

About Kellie Bradford Md NPPES

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

KELLIE BRADFORD MD (NPI 1538726161) is an individual student in an organized health care education/training program in Canton, Ohio and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1538726161
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKELLIE BRADFORDCredential: MD
Location Address2600 SIXTH ST SWCanton, OH 44710-1702
Mailing Address2600 Sixth St SwCanton, OH 44710-1702 · (330) 363-6326
Phone(330) 363-6326
Sole ProprietorNo
Enumeration DateMay 20, 2019
Last NPPES UpdateFebruary 6, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 6, 2024
✔ NPI 1538726161 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.
2600 SIXTH ST SW, Canton, OH 44710
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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)

Kellie Bradford 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.

Other Providers at the Same Location NPPES 20

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

CHELSEA FLIGHT CNP
Nurse Practitioner
2600 SIXTH ST SW
CANTON, OH 44710
Stark County (330) 363-0000
JAIME MARIE RENNECKER
Nurse Practitioner (Neonatal)
2600 SIXTH ST SW
CANTON, OH 44710
Stark County (330) 363-5433
JARELIZ CALDAS DIAZ MD
Student in an Organized Health Care Education/Training Program
2600 SIXTH ST SW
CANTON, OH 44710
Stark County (330) 363-6223
YARA KHOURI M.D.
Internal Medicine
2600 SIXTH ST SW
CANTON, OH 44710
Stark County (330) 363-6235
HEATHER BAKER AGACNP
Nurse Practitioner (Acute Care)
2600 SIXTH ST SW
CANTON, OH 44710
Stark County (330) 452-9911
SHELBY WESTHOEFER
Nurse Practitioner
2600 SIXTH ST SW
CANTON, OH 44710
Stark County (330) 452-9911
MR. KEVIN WHITE C.R.N.A.
Nurse Anesthetist, Certified Registered
2600 SIXTH ST SW
CANTON, OH 44710
Stark County (330) 363-7462
DR. DOUGLAS ALLEN WOOD DO
Emergency Medicine
2600 SIXTH ST SW
CANTON, OH 44710
Stark County (330) 456-2695

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 Kellie Bradford's NPI number?

The NPI number for Kellie Bradford is 1538726161. It was assigned to this individual provider in the NPPES registry on May 20, 2019.

Where is Kellie Bradford located?

Kellie Bradford practices at 2600 Sixth St SW, Canton, OH 44710. The listed phone number is (330) 363-6326.

What is Kellie Bradford's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kellie Bradford enrolled in Medicare?

Yes. Kellie Bradford is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kellie Bradford was last updated on February 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.