Individual provider Active NPI

Bradley Kyle Parker, DNP, APRN, FNP-BC

  • Family Nurse Practitioner
  • Springfield, TN
National Provider Identifier
1376292003
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
35553 Issued in TN
Practice address
6407 New Cut Rd
Springfield, TN 37172-1660
Phone
(615) 336-5908
NPI assigned
Mar 21, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 220465 TN
Family Nurse Practitioner 363LF0000X 35553 TN Primary

Addresses

Primary practice location

6407 New Cut Rd
Springfield, TN 37172-1660

Mailing address

6407 New Cut Rd
Springfield, TN 37172-1660
Phone (615) 336-5908

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240517002669 TN Practitioner - Nurse Practitioner 3678914884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coffee County Hospital Group IncGroup PAC ID 1456317783, 87 clinicians

Practice addresses (Care Compare)

482 Interstate Dr
Suite a
Manchester, TN 37355-3109
Phone (931) 728-4718

Hospital & facility affiliations

  • NHC Homecare Springfield Home health agency, Springfield, TN, CCN 447276
  • Accentcare Home Health of Nashville Home health agency, Franklin, TN, CCN 447566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
220465TNMDRegistered Nurse
35553TNMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coffee Medical Group LLC CurrentSince Apr 6, 2024 Accepting new patients
Coffee Medical Group LLC CurrentSince Apr 6, 2024 Accepting new patients
Geriatric Consulting Group PC Past Accepting new patients

Locations

482 Interstate Dr
Manchester, TN 37355
Phone (931) 728-4718

481 Interstate Dr
Manchester, TN 37355
Phone (931) 728-3586

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1376292003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6407 NEW CUT RD",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371721660",
            "telephone_number": "615-336-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6407 NEW CUT RD",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371721660",
            "telephone_number": "615-336-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "BRADLEY",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-21",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "220465",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "35553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, TN

Sources for this page

Verify at the official NPI Registry.