Jesse H. Bradley Jr., D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

242 Issued in AR

Practice address

116 W Tyler Ave
Suite B
West Memphis, AR 72301-4221

Phone

(870) 733-0888

Fax

(870) 733-0889

NPI assigned

Apr 16, 2009

Last updated

Jul 22, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 3

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital-Crittenden, Inc Hospital, West Memphis, AR, CCN 040156
• Forrest City Medical Center Hospital, Forrest City, AR, CCN 040019

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: bradleyfootcare@bfc-ar.direct.office.nextgen.com
• Direct secure messaging: jbradl32@yourcarecommunity.org

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.

• Bradley Footcare LLC

  • Foot & Ankle Surgery Podiatrist
  • West Memphis, AR
  • NPI 1477881092
  Medicare reassignment Authorized official

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

• Baptist Memorial Hospital - Crittenden Inc

  • General Acute Care Hospital
  • West Memphis, AR
  • NPI 1437634524
  Care Compare affiliation
• Forrest City Arkansas Hospital Company LLC

  dba Forrest City Medical Center

  • General Acute Care Hospital
  • Forrest City, AR
  • NPI 1811912009
  Care Compare affiliation

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1114160389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1752",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723031752",
            "telephone_number": "870-733-0888",
            "fax_number": "870-733-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W TYLER AVE",
            "address_2": "SUITE B",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014221",
            "telephone_number": "870-733-0888",
            "fax_number": "870-733-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "JESSE",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-16",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MS",
            "license": "80197",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2007024292",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TN",
            "license": "695",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AR",
            "license": "242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180310717",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180372748",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199945716",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William D Bond, BS PHARMACIST
• Julianna Boskus, DDS
• Robert Blake Bowman, DDS
• Latoria Ann Boyland, PSYCH DNP
• Bradley Footcare LLC
• Erin Brakebill, MS, CF-SLP
• Dorcas Ann Brazile, BSW
• Kevin Lee Breckenridge, PTA
• Hannah Lee Brenner
• Brian D. Rhoads DDS, PC

• Foot & Ankle Surgery Podiatrist in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Foot & Ankle Surgery Podiatrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.