Individual provider Active NPI

Jerry Allen Bradley Jr., MD, EDD, MDIV

  • Geriatric Medicine (Family Medicine) Physician
  • Mobile, AL
National Provider Identifier
1376882563
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
MD.34716 Issued in AL
Practice address
575 Stanton Rd
Mobile, AL 36617-2344
Phone
(251) 471-7207
Fax
(251) 471-7207
NPI assigned
Feb 7, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X MD.34716 AL
Geriatric Medicine (Family Medicine) Physician 207QG0300X MD.34716 AL Primary

Addresses

Primary practice location

575 Stanton Rd
Mobile, AL 36617-2344

Mailing address

PO Box 746450
Atlanta, GA 30374-6450
Phone (866) 401-3057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250723000053 AL Practitioner - Family Practice 1658660816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
USA Health Physician Billing Services LLCGroup PAC ID 9931436912, 342 clinicians

Practice addresses (Care Compare)

2451 University Hospital Dr
Mobile, AL 36617-2300
Phone (251) 471-7000

75 S University Blvd
Unit 6000
Mobile, AL 36608-3274
Phone (251) 660-5555

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.34716ALMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
USA Health Physician Billing Services LLC CurrentSince Jul 1, 2025 Accepting new patients
USA Health Physician Billing Services LLC Family Medicine CurrentSince Jul 1, 2025 Accepting new patients

Locations

75 S University Blvd
Unit 6500
Mobile, AL 36608
Phone (251) 445-8282

75 S University Blvd
Unit 6000
Mobile, AL 36608
Phone (251) 660-5555

1720 Center St
Mobile, AL 36604
Phone (251) 410-4764

575 Stanton Rd
Mobile, AL 36617
Phone (251) 471-7207

Interoperability endpoints

  • Direct secure messaging: jbradley104273@direct.owensborohealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1376882563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746450",
            "telephone_number": "866-401-3057",
            "fax_number": "318-868-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 STANTON RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172344",
            "telephone_number": "251-471-7207",
            "fax_number": "251-471-7207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "JERRY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD, EDD, MDIV",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-07",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "AL",
            "license": "MD.34716",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AL",
            "license": "MD.34716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.