Individual provider Active NPI

Robert M Bradley, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Memphis, TN
National Provider Identifier
1124002704
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
015294 Issued in TN
Practice address
1265 Union Ave
Dept of Pathology, 6 Sherard
Memphis, TN 38104
Phone
(901) 516-7182
Fax
(901) 276-5474
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 15294 MS
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 015294 TN Primary

Addresses

Primary practice location

1265 Union Ave
Dept of Pathology, 6 Sherard
Memphis, TN 38104

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Other practice location 1

4250 Bethel Rd Dept Of
Olive Branch, MS 38654-8737
Phone (901) 516-7182

Other identifiers 1

IdentifierTypeStateIssuer
3093072MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040415000629 TN Practitioner - Pathology 0648265173 Reassigns benefits to 1 organization
I20151116002675 MS Practitioner - Pathology 0648265173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Vanderbilt University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Specialists of Memphis PCGroup PAC ID 5193117364, 15 clinicians

Practice addresses (Care Compare)

1265 Union Ave
Memphis, TN 38104-3415
Phone (901) 516-7182

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (901) 516-7182

Hospital & facility affiliations

  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015294TNMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Specialists of Memphis PC CurrentSince Mar 1, 2022 Accepting new patients
Methodist Surgery Center Germantown LP Current Accepting new patients
Duckworth Laboratories Inc. Current Accepting new patients

Locations

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

1363 S Germantown Rd
Memphis, TN 38138
Phone (901) 516-6000

1265 Union Ave
#6
Memphis, TN 38104
Phone (901) 726-2305

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1211 Union Ave
Ste 300
Memphis, TN 38104
Phone (901) 725-7551

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

Interoperability endpoints

  • Direct secure messaging: rbradley31972@mlh.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1124002704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UNION AVE",
            "address_2": "DEPT OF PATHOLOGY, 6 SHERARD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38104",
            "telephone_number": "901-516-7182",
            "fax_number": "901-276-5474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4250 Bethel Rd Dept Of",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386548737",
            "country_code": "US",
            "telephone_number": "901-516-7182",
            "fax_number": "901-276-5474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "ROBERT",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MS",
            "license": "15294",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "015294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3093072",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.