Bradley Seaton Thedinger, MD

Key facts

NPI

1316914005

Entity type

Individual (NPI type 1)

Primary specialty

Otology & Neurotology Physician 207YX0901X

License

R7F10 (MO)

Practice address

3100 Broadway Suite 509
Kansas City, MO 64111-2413

Phone

(816) 531-7373

Fax

(816) 531-1404

NPI assigned

Mar 2, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 1

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.

• Midwest Ear Institute Inc Audiologist · Kansas City, MO · NPI 1992742233
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

Practice roles

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 15, 2012.

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1316914005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 BROADWAY SUITE 509",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112413",
            "telephone_number": "816-531-7373",
            "fax_number": "816-531-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 BROADWAY SUITE 509",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112413",
            "telephone_number": "816-531-7373",
            "fax_number": "816-531-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEDINGER",
        "first_name": "BRADLEY",
        "middle_name": "SEATON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "MO",
            "license": "R7F10",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100152510C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Kansas City, MO · Otology & Neurotology Physician in Missouri