Bradley Daniel Page, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

004775 Issued in GA

Practice address

2005 Pioneer St Ste C
Waycross, GA 31501-6205

Phone

(912) 490-7777

Fax

(912) 490-7778

NPI assigned

May 2, 2006

Last updated

Feb 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Faith Family Practice LLCGroup PAC ID 3072934520, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Satilla Health Hospital, Waycross, GA, CCN 110003

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

• Faith Family Practice LLC

  • Family Medicine Physician
  • Waycross, GA
  • NPI 1649819343
  Medicare reassignment Care Compare group
• Southeast Georgia Primary Care

  • Family Medicine Physician
  • Waycross, GA
  • NPI 1053429688
  NPD
• Jesup Emergency Services, LLC

  • Emergency Medicine Physician
  • Jesup, GA
  • NPI 1699733832

  Medical

  NPD (past)
• Mayo Clinic Health System in Waycross, Inc.

  • Multi-Specialty Clinic/Center
  • Waycross, GA
  • NPI 1154745982
  NPD (past)

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

• Southeast Georgia Health Services, L.L.C.

  dba Memorial Satilla Health

  • Rural Acute Care Hospital
  • Waycross, GA
  • NPI 1922530468
  Care Compare affiliation

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1265490098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11608 CENTRAL AVE",
            "city": "HOBOKEN",
            "state": "GA",
            "postal_code": "315422106",
            "telephone_number": "912-288-3417",
            "fax_number": "912-283-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 PIONEER ST STE C",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016205",
            "telephone_number": "912-490-7777",
            "fax_number": "912-490-7778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 Knight Ave",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315011943",
            "country_code": "US",
            "telephone_number": "912-283-9423",
            "fax_number": "912-283-8204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAGE",
        "first_name": "BRADLEY",
        "middle_name": "DANIEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "004775",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "4755",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orthopedic Surgeons of Georgia LLC (Optim Orthopedics)
• Orthopedics Surgeons of Georgia, LLC (Optim Orthopedics - Waycross)
• Regina Osime, LCSW
• P. Maramreddy, M.D., P.C.
• Packer Medical Services,LLC (Packer Medical Services)
• Pain Associates of South Georgia LLC (Pain Associates of South Georgia)
• Pam Wheeler Host Home
• Paresh K Thanki, MD, LLC
• Rosemarie D Parks, MD
• Joshua K Parmelee, OD

• Medical Physician Assistant in Waycross, GA
• Providers in Waycross, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.