ROYAL BRADLEY (APRN) – Nurse Practitioner, NPI 1043769185

ROYAL BRADLEY (APRN) is a healthcare provider. based in Henderson, Nevada. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. APRN 002343 (NV). The NPI Number for ROYAL BRADLEY (APRN) is 1043769185

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
ROYAL BRADLEY (APRN)
NPI
1043769185
Phone
(702) 335-4125
Address
247 Coopergrove Dr
Enumeration Date
30 September 2016
Last Update Date
5 March 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7024096849
Graduation Year
2016 (10 years ago)
PAC ID
6002197571
Group Practice PAC ID
6507394046
Professional Enrollment ID
I20161222000398
Address ID
NV891214304LA3910XINTE401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

2,947 NURSE PRACTITIONER in NV

Provider Addresses for ROYAL BRADLEY (APRN)

  • 247 Coopergrove Dr

    Henderson, NV 890746022

    Phone: (702) 335-4125

    Type: Location

  • 2210, East Calvada Boulevard, Pahrump, Nye County, Nevada, 89048, United States

    PAHRUMP, NV 89048

    Phone: (702) 877-5199

    Type: Location

  • McCarran International Airport, 5757, Wayne Newton Boulevard, Enterprise, Clark County, Nevada, 89154, United States

    LAS VEGAS, NV 891335380

    Phone: (702) 877-5199

    Type: Mailing

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: 2016-12-22

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
I20161222000398INurse PractitionerNVTBD

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 89074)

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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: 6507394046View full group profile
NameSpecialtyState
Nurse PractitionerNV

Reviews

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Frequently asked questions

How is ROYAL BRADLEY (APRN) identified in CMS data?
CMS-hosted NPPES data lists ROYAL BRADLEY (APRN) with NPI 1043769185.
Is ROYAL BRADLEY (APRN) listed as active for patients and plans?
The listing shows ROYAL BRADLEY (APRN) as active in the NPI system.
What healthcare role does ROYAL BRADLEY (APRN) hold?
Scheduling teams often label ROYAL BRADLEY (APRN) under Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What area does ROYAL BRADLEY (APRN) serve?
ROYAL BRADLEY (APRN)'s listing highlights Henderson, Nevada; more addresses can appear in NPPES.
Why does ROYAL BRADLEY (APRN) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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