NPIMap

Organization Active NPI

Bradley Pediatrics

  • Specialist
  • Cleveland, TN
National Provider Identifier
1154417152
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
21336 Issued in TN
Legal business name
BRADLEY PEDIATRICS
Practice address
2825 Westside Dr NW
Ste C
Cleveland, TN 37312-3505
Phone
(423) 614-3733
Fax
(423) 614-3738
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Authorized official

Name
Brandi Bivens
Title
Coding Supervisor
Phone
(423) 339-2330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 21336 TN Primary

Addresses

Primary practice location

2825 Westside Dr NW
Ste C
Cleveland, TN 37312-3505

Mailing address

2825 Westside Dr NW
Ste C
Cleveland, TN 37312-3505
Phone (423) 614-3733

National Provider Directory

National Provider Directory
Tax ID family
Bradley Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2825 Westside Dr NW
Ste C
Cleveland, TN 37312
Phone (423) 476-3258

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436486400000",
    "number": "1154417152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 WESTSIDE DR NW",
            "address_2": "STE C",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123505",
            "telephone_number": "423-614-3733",
            "fax_number": "423-614-3738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 WESTSIDE DR NW",
            "address_2": "STE C",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123505",
            "telephone_number": "423-614-3733",
            "fax_number": "423-614-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2015-07-10",
        "status": "A",
        "authorized_official_last_name": "BIVENS",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "CODING SUPERVISOR",
        "authorized_official_telephone_number": "423-339-2330"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "21336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.