Individual provider Active NPI

Brady Bostick Rives, AU.D.

  • Audiologist
  • Selma, AL
National Provider Identifier
1255749495
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1127A Issued in AL
Practice address
4 Office Park Cir
Selma, AL 36701-6538
Phone
(334) 872-9711
Fax
(334) 874-7574
NPI assigned
Jul 31, 2014
Last updated
Jul 31, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1127A AL Primary

Addresses

Primary practice location

4 Office Park Cir
Selma, AL 36701-6538

Mailing address

4 Office Park Cir
Selma, AL 36701-6538
Phone (334) 872-9711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150205001714 AL Practitioner - Qualified Audiologist 1658696042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

203 Dallas Ave
Selma, AL 36701-5744
Phone (334) 872-9711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1127AALMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Alabama Audiology, LLC Audiologist CurrentSince Jul 15, 2014 Accepting new patients
Song Eye Center PastSince Sep 3, 2002 Accepting new patients

Locations

1100 Medical Center Pkwy
Selma, AL 36701
Phone (334) 872-9711

203 Dallas Ave
Selma, AL 36701
Phone (334) 872-9711

4 Office Park Cir
Selma, AL 36701
Phone (205) 872-6216

406 Dallas Ave
Selma, AL 36701
Phone (334) 878-2020

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": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406764800000",
    "number": "1255749495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 OFFICE PARK CIR",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367016538",
            "telephone_number": "334-872-9711",
            "fax_number": "334-874-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 OFFICE PARK CIR",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367016538",
            "telephone_number": "334-872-9711",
            "fax_number": "334-874-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVES",
        "first_name": "BRADY",
        "middle_name": "BOSTICK",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AL",
            "license": "1127A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.