KELLY BRADFORD – Clinical Social Worker, NPI 1386906394

KELLY BRADFORD is a healthcare provider. based in Independence, Kansas. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 995 (KS). The NPI Number for KELLY BRADFORD is 1386906394

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
KELLY BRADFORD
NPI
1386906394
Phone
Not provided
Address
PO BOX 688
Enumeration Date
14 June 2012
Last Update Date
28 August 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6203311748
Graduation Year
2012 (14 years ago)
PAC ID
2769755057
Group Practice PAC ID
7012904071
Professional Enrollment ID
I20170908000209
Address ID
KS673017841IN3354X160X300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:13State licenses:2Digital endpointsOther names

832 CLINICAL SOCIAL WORKER in KS

Provider Addresses for KELLY BRADFORD

  • PO BOX 688

    INDEPENDENCE, KS 673010688

    Phone:

    Type: Mailing

  • 1101 DONALD AVE

    INDEPENDENCE, KS 673012001

    Phone: (620) 331-1748

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-09-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170908000209IClinical Social WorkerKSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 67301)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012904071View full group profile
NameSpecialtyState
Physician AssistantKS
-KS
Mental Health CounselorKS
Nurse PractitionerKS
Nurse PractitionerKS
-TX
Mental Health CounselorKS
Physician AssistantKS
Clinical Social WorkerKS
Mental Health CounselorKS

Reviews

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Frequently asked questions

How do I look up KELLY BRADFORD by NPI?
Use NPI 1386906394 when you need to reference KELLY BRADFORD in forms, claims, or directories.
Is KELLY BRADFORD currently active in the NPI registry?
CMS-published data lists KELLY BRADFORD as an active registrant.
What field does KELLY BRADFORD work in?
You can think of KELLY BRADFORD as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What location metadata exists for KELLY BRADFORD?
The page summarizes Independence, Kansas for KELLY BRADFORD; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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