Stanley Bradley, MD

Primary specialty

Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X

License

C-5957 Issued in AR

Practice address

325 E Longview Street
Fayetteville, AR 72703-4618

Phone

(479) 463-7385

Fax

(479) 444-7120

NPI assigned

Apr 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sbradley25237@washingtonregional.direct-ci.com

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

• Washington Regional Medical System

  • Hospitalist Physician
  • Fayetteville, AR
  • NPI 1306801485

  AR

  Medicare reassignment NPD
• Washington Regional Medical System

  • Family Medicine Physician
  • Farmington, AR
  • NPI 1275839011

  Family Medicine

  NPD
• Washington Regional Medical System

  • Geriatric Psychiatry Physician
  • Fayetteville, AR
  • NPI 1366408973
  NPD
• St Marys Physician Services, LLC

  • Interventional Cardiology Physician
  • Russellville, AR
  • NPI 1720356207
  NPD (past)
• Washington Regional Medical System

  • Infectious Disease Physician
  • Fayetteville, AR
  • NPI 1346175387
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1073579322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 E LONGVIEW STREET",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034618",
            "telephone_number": "479-463-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E LONGVIEW STREET",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034618",
            "telephone_number": "479-463-7385",
            "fax_number": "479-444-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "STANLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C-5957",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "AR",
            "license": "C-5957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103929001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney L Bradley
• Katelyn Nicole Bradley
• Lakisha M. Bradley, LAC
• Matthew S Bradley, MD
• Rebecca Bradley
• Erin S Brady, DDS
• Jana Lynn Brady, L.AC., DOM
• Raj Brahmbhatt, DDS
• Brainpower Neuropsychology, PLC
• Kevin Drake Branch, M.D.

• All providers in Fayetteville, AR
• Hospice and Palliative Medicine (Family Medicine) Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.