Active NPI
Scot L Bradley, MD
- Pulmonary Disease Physician
- Spokane, WA
National Provider Identifier
1174525802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- MD00017119
- Practice address
- 400 E 5TH Ave
Spokane, WA 99202-1334 - Phone
- (509) 838-2531
- NPI assigned
- Aug 12, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | MD00017119 | WA | Primary |
Addresses
Primary practice location
400 E 5TH Ave
Spokane, WA 99202-1334
Mailing address
PO Box 3649
Spokane, WA 99220-3649
Phone (509) 838-2531
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8217705 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00017119 | WA | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rockwood Clinic PS | Current | Accepting new patients | |
| Rockwood Clinic PS | Past | Accepting new patients |
Locations
910 W 5th Ave
Ste 800
Spokane, WA 99204
Phone (509) 755-5120
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 and National Provider Directory roles.
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- Internal Medicine Physician
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-
- Durable Medical Equipment & Medical Supplies
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- NPI 1558760470
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229040000000",
"number": "1174525802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3649",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992203649",
"telephone_number": "509-838-2531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E 5TH AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992021334",
"telephone_number": "509-838-2531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "SCOT",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-12",
"last_updated": "2008-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "WA",
"license": "MD00017119",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8217705",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.