Individual provider Active NPI

Bradley Wayne Housman, MD

  • Obstetrics & Gynecology Physician
  • Paducah, KY
National Provider Identifier
1033283247
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
33501 Issued in KY
Practice address
2603 Kentucky Ave
Suite 302
Paducah, KY 42003
Phone
(270) 575-4551
Fax
(270) 575-4560
NPI assigned
Nov 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 33501 KY Primary

Addresses

Primary practice location

2603 Kentucky Ave
Suite 302
Paducah, KY 42003

Mailing address

PO Box 9685
Paducah, KY 42002-9685
Phone (270) 575-4551

Other identifiers 2

IdentifierTypeStateIssuer
000000188608OtherKYBCBS
64014103MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33501KYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Owens Obstetrics and Gynecology PSC Obstetrics & Gynecology 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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033283247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9685",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420029685",
            "telephone_number": "270-575-4551",
            "fax_number": "270-575-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 KENTUCKY AVE",
            "address_2": "SUITE 302",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "42003",
            "telephone_number": "270-575-4551",
            "fax_number": "270-575-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSMAN",
        "first_name": "BRADLEY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "33501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000188608",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64014103",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.