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LARISA BRADFORD LLC
NPI 1629803754
Family Medicine in Gainesville, GA

Active since September 06, 2024
808 MAIN ST SW, GAINESVILLE, GA 30501(404) 808-6071 Get Directions Write a Review

NPPES record last updated: January 23, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Dec 5, 2024, Nov 22, 2024, Sep 6, 2024 (3 updates tracked since 2024).

About Larisa Bradford Llc NPPES

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

LARISA BRADFORD LLC (NPI 1629803754) is a healthcare organization registered as a family medicine in Gainesville, Georgia and active in the NPI registry since September 2024. The organization lists Larisa Russell, Owner/medical Doctor, as its authorized official.

NPPES Registry Identity

NPI1629803754
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLARISA BRADFORD LLC
Location Address808 MAIN ST SWGainesville, GA 30501-4472
Mailing Address808 Main St SwGainesville, GA 30501-4472 · (404) 808-6071
Phone(404) 808-6071
Organization SubpartNo
Authorized OfficialLarisa RussellOwner/medical Doctor · (404) 808-6071
Enumeration DateSeptember 6, 2024
Last NPPES UpdateJanuary 23, 20253 updates tracked since enumeration
NPPES CertifiedJanuary 23, 2025
✔ NPI 1629803754 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
808 MAIN ST SW, Gainesville, GA 30501
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Larisa Bradford LLC's NPI number?

The NPI number for Larisa Bradford LLC is 1629803754. It was assigned to this organization in the NPPES registry on September 6, 2024.

Where is Larisa Bradford LLC located?

Larisa Bradford LLC is located at 808 Main St SW, Gainesville, GA 30501. The listed phone number is (404) 808-6071.

What is Larisa Bradford LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Larisa Bradford LLC was last updated on January 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.