Individual provider Active NPI

Bradley Alan Hedges, PH.D.

  • Counseling Psychologist
  • Lancaster, OH
National Provider Identifier
1225262520
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
4581 Issued in OH
Practice address
624 E Main St
Lancaster, OH 43130-3903
Phone
(740) 475-0488
Fax
(740) 409-6976
NPI assigned
May 14, 2009
Last updated
Jul 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X E1282-SUPV OH
Counseling Psychologist 103TC1900X 4581 OH Primary

Addresses

Primary practice location

624 E Main St
Lancaster, OH 43130-3903

Mailing address

624 E Main St
Lancaster, OH 43130-3903
Phone (740) 475-0488

Other identifiers 1

IdentifierTypeStateIssuer
0891816MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091106000210 OH Practitioner - Clinical Psychologist 7113949454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bhconsultation LLCGroup PAC ID 6305234311, 3 clinicians

Practice addresses (Care Compare)

624 E Main St
Lancaster, OH 43130-3903
Phone (740) 475-0488

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E1282-SUPVOHMDMental Health Counselor
4581OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Ohio Psychological Services Inc Mental Health CurrentSince Oct 5, 2021 Accepting new patients
Bhconsultation, LLC CurrentSince Jul 15, 2021 Accepting new patients

Locations

106 Starret St
Ste 100
Lancaster, OH 43130
Phone (740) 687-0042

624 E Main St
Lancaster, OH 43130
Phone (740) 475-0488

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Fairfield Medical CenterLancaster, OH, CCN 360072 Hospital Corporate Director Jun 1, 2018
Primary Care New LexingtonNew Lexington, OH, CCN 363443 Rural health clinic Corporate Director Aug 27, 2020

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1225262520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 E MAIN ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303903",
            "telephone_number": "740-475-0488",
            "fax_number": "740-409-6976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E MAIN ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303903",
            "telephone_number": "740-475-0488",
            "fax_number": "740-409-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDGES",
        "first_name": "BRADLEY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-14",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E1282-SUPV",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OH",
            "license": "4581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0891816",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.