Individual provider Active NPI

Bradley Mark Townsend, M.D.

  • Family Medicine Physician
  • Clinton, MO
National Provider Identifier
1033205521
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R8F34 Issued in MO
Practice address
1413 South Second Street
Clinton, MO 64735
Phone
(660) 885-7776
Fax
(575) 205-0346
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R8F34 MO Primary

Addresses

Primary practice location

1413 South Second Street
Clinton, MO 64735

Mailing address

PO Box 393
Clinton, MO 64735-0393
Phone (660) 885-7776

Other identifiers 1

IdentifierTypeStateIssuer
202555629MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041221000913 MO Practitioner - Family Practice 1557329612 Practice locations: Clinton, MO

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1413 S 2ND St
Clinton, MO 64735-2831
Phone (660) 885-7776

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R8F34MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1033205521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 393",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647350393",
            "telephone_number": "660-885-7776",
            "fax_number": "575-205-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 SOUTH SECOND STREET",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "64735",
            "telephone_number": "660-885-7776",
            "fax_number": "575-205-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOWNSEND",
        "first_name": "BRADLEY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-10-28",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R8F34",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202555629",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MO

Sources for this page

Verify at the official NPI Registry.