Bradley Kyle Rodell

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5848 Issued in TN

Practice address

1574 Medical Center Pkwy Ste 104
Murfreesboro, TN 37129-3761

Phone

(615) 225-2070

Fax

(615) 962-9047

NPI assigned

Feb 22, 2019

Sex

Male

Sole proprietor

Yes

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 WA, TN2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gateway Healthcare, PCGroup PAC ID 7416228366, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Gateway Healthcare, PC

  • Urgent Care Clinic/Center
  • Murfreesboro, TN
  • NPI 1770035214
  Medicare reassignment Care Compare group
• North Olympic Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Port Angeles, WA
  • NPI 1639036924
  NPD
• North Olympic Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Port Angeles, WA
  • NPI 1700526852
  NPD
• Gateway Primary Care LLC

  • Primary Care Clinic/Center
  • Murfreesboro, TN
  • NPI 1912688250

  Single Specialty

  NPD (past)
• Emedical Group Inc

  • Health Service Clinic/Center
  • Troy, AL
  • NPI 1457644742

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1427515782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W FRONT ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983622609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1574 MEDICAL CENTER PKWY STE 104",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293761",
            "telephone_number": "615-225-2070",
            "fax_number": "615-962-9047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 S Church St Ste B",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371277218",
            "country_code": "US",
            "telephone_number": "615-639-5515",
            "fax_number": "615-639-5505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5607 Franklin Rd Ste A1",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371283547",
            "country_code": "US",
            "telephone_number": "615-962-7727",
            "fax_number": "615-962-7729",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3266 Memorial Blvd Ste F",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371295484",
            "country_code": "US",
            "telephone_number": "615-900-3515",
            "fax_number": "615-900-3463",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "240 W Front St",
            "address_purpose": "LOCATION",
            "city": "Port Angeles",
            "state": "WA",
            "postal_code": "983622609",
            "country_code": "US",
            "telephone_number": "360-452-7891",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1636 New Salem Hwy Ste D",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371287038",
            "country_code": "US",
            "telephone_number": "615-900-1176",
            "fax_number": "615-203-6142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODELL",
        "first_name": "BRADLEY",
        "middle_name": "KYLE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-22",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "60932663",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Lynn Robinson
• Steven Andrew Robinson, D.D.S.
• Timothy Dean Roche Jr., PHARMD
• Julie Frances Rockwell, DO
• Rocky Mountain Holdings, LLC
• Javier Francisco Rodriguez, PA
• Robert Alan Rodriguez, MD
• Taylor Rodriguez, PHARMD
• Amy Michelle Roeder, DDS
• Alexandra Rogers, LPC-MHSP

• Physician Assistant in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.