Individual provider Active NPI

Bradley Layton

  • Emergency Medicine Physician
  • Lansing, MI
National Provider Identifier
1053637322
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
49958 Issued in TN
Practice address
1215 E Michigan Ave
Lansing, MI 48912-1811
Phone
(517) 364-2583
NPI assigned
Apr 12, 2010
Last updated
Jul 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 49958 TN Primary

Addresses

Primary practice location

1215 E Michigan Ave
Lansing, MI 48912-1811

Mailing address

3981 Burwood Place Dr
Thompsons Station, TN 37179-1020
Phone (520) 437-1418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20130618000054 TN Practitioner - Emergency Medicine 5698914976 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49958TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Tennessee Emergency Physicians PC Emergency Medicine CurrentSince Feb 1, 2024 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jun 13, 2013 Accepting new patients

Locations

1224 Trotwood Ave
Columbia, TN 38401
Phone (931) 380-4072

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1080 N Ellington Pkwy
Lewisburg, TN 37091
Phone (615) 359-6241

2000 Church St
Nashville, TN 37236
Phone (615) 284-4672

Organizations & group practices 2

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": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1053637322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3981 BURWOOD PLACE DR",
            "city": "THOMPSONS STATION",
            "state": "TN",
            "postal_code": "371791020",
            "telephone_number": "520-437-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAYTON",
        "first_name": "BRADLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-12",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "49958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.