NPIMap

Individual provider Active NPI

Bradley S Ellison, MD

  • Orthopaedic Surgery Physician
  • Concord, NC
National Provider Identifier
1205037116
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2015-01521 Issued in NC
Practice address
354 Copperfield Blvd NE
Concord, NC 28025-2402
Phone
(704) 323-2000
NPI assigned
May 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 0101247812 VA
Orthopaedic Surgery Physician 207X00000X 2015-01521 NC Primary

Addresses

Primary practice location

354 Copperfield Blvd NE
Concord, NC 28025-2402

Mailing address

4601 Park Rd
Suite 250
Charlotte, NC 28209-3239
Phone (704) 323-2000

Other identifiers 2

IdentifierTypeStateIssuer
1205037116MedicaidNC
Q0152NMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150902003283 NC Practitioner - Orthopedic Surgery 5092851931 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians
OrthocarolinaGroup PAC ID 2062316821, 288 clinicians
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

354 Copperfield Blvd NE
Concord, NC 28025-2402
Phone (704) 323-2276

6604 Roberta Rd
Harrisburg, NC 28075-9532
Phone (419) 221-6717

7482 Waterside Crossing Blvd
Denver, NC 28037-3006
Phone (704) 827-0598

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement27
Knee replacement61
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015-01521NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocarolina Orthopaedic Surgery CurrentSince Jul 6, 2015 Accepting new patients
Carolinas Physicians Network Inc Orthopaedic Surgery CurrentSince Sep 9, 2024 Accepting new patients
Carolinas Physicians Network Inc Orthopaedic Surgery Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Sep 9, 2024 Accepting new patients
Orthocarolina Orthopaedic Surgery CurrentSince Jul 6, 2015 Accepting new patients
Orthocarolina Orthopaedic Surgery Past Accepting new patients

Locations

105 Yadkin St
Ste 101
Albemarle, NC 28001
Phone (704) 474-3171

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090

1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000

354 Copperfield Blvd NE
Concord, NC 28025
Phone (704) 262-4181

Interoperability endpoints

  • Direct secure messaging: bellison536378@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1205037116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD",
            "address_2": "SUITE 250",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093239",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 COPPERFIELD BLVD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252402",
            "telephone_number": "704-323-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "BRADLEY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "VA",
            "license": "0101247812",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2015-01521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205037116",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0152N",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.