Individual provider Active NPI

Judith Lynn Bradley, M.D.

  • Ophthalmology Physician
  • Laurel, MS
National Provider Identifier
1457466690
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
11338 Issued in MS
Practice address
1020 Adams St
Laurel, MS 39440-4365
Phone
(601) 426-9454
Fax
(601) 426-9476
NPI assigned
Aug 20, 2006
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 11338 MS Primary

Addresses

Primary practice location

1020 Adams St
Laurel, MS 39440-4365

Mailing address

PO Box 247
Laurel, MS 39441-0247
Phone (601) 399-6169

Other identifiers 1

IdentifierTypeStateIssuer
0015203MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20110329000741 MS Practitioner - Ophthalmology 6800784570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Mississippi School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Central Clinics, IncGroup PAC ID 4385876655, 117 clinicians

Practice addresses (Care Compare)

1002 Jefferson St
Laurel, MS 39440-4306

1020 Adams St
Laurel, MS 39440-4365
Phone (601) 426-9454

1203 Ave B
Ellisville, MS 39437-2080
Phone (601) 477-2226

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery235

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Clinics, Inc CurrentSince Dec 1, 2019 Accepting new patients
South Central Clinics, Inc. Ophthalmology CurrentSince Dec 1, 2019 Accepting new patients
South Central Clinics, Inc Current Accepting new patients
South Central Clinics, Inc. Past Accepting new patients

Locations

1203 B Ave
Ellisville, MS 39437
Phone (601) 477-8553

1020 Adams St
Laurel, MS 39440
Phone (601) 426-9454

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1457466690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410247",
            "telephone_number": "601-399-6169",
            "fax_number": "601-399-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 ADAMS ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404365",
            "telephone_number": "601-426-9454",
            "fax_number": "601-426-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "JUDITH",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "11338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015203",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.