Bradley Noel Greenhaw, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

23810 Issued in MS

Practice address

516 Pegram Dr
Tupelo, MS 38801-6347

Phone

(662) 844-6272

Fax

(662) 844-1603

NPI assigned

Jul 8, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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 1

Specialty

Dermatology

Education

University of Mississippi School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Center of North Ms PAGroup PAC ID 7416006986, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.27 of 100Reported as individual

Quality

93.22

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Dermatology Center of North Ms PA

  • Dermatology Physician
  • Tupelo, MS
  • NPI 1053491605
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1215249131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 PEGRAM DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016347",
            "telephone_number": "662-844-6272",
            "fax_number": "662-844-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 PEGRAM DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016347",
            "telephone_number": "662-844-6272",
            "fax_number": "662-844-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENHAW",
        "first_name": "BRADLEY",
        "middle_name": "NOEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-08",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MS",
            "license": "23810",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MS",
            "license": "23810",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MS",
            "license": "23810",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEMPORART MS MEDICAL LICENSE NUMBER",
            "identifier": "T-2318",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Asya Tierra Green
• Charlotte Renae Green, PMHNP-BC
• Gerry Bowen Green, DMD
• Jamie Leigh Green, RN
• Teresa Green, RBT
• Curtis Greer, MD
• Bryanna Grice
• Jessica N Griffin, CFNP
• Toya Griffin, MSW/CMHT
• Donna Grisham

• Dermatology Physician in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Dermatology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; 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.