Alli Nickell Bradley, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5441 Issued in TN

Practice address

1404 Tusculum Blvd Ste 3000
Greeneville, TN 37745-4648

Phone

(423) 638-1188

Fax

(833) 908-2068

NPI assigned

May 24, 2021

Last updated

Aug 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alli Johanna Nickell Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Edward Via Col of Osteo Medicine-Virginia Campus, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Care Home health agency, Morristown, TN, CCN 447190
• Greeneville Community Hospital Hospital, Greeneville, TN, CCN 440050

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alli.bradley.1@20785.direct.athenahealth.com

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.

• Summit Medical Group, PLLC

  dba Cool Springs Internal Medicine and Pediatrics

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment Care Compare group NPD
• Summit Medical Group, PLLC

  • Internal Medicine Physician
  • Knoxville, TN
  • NPI 1548349186

  Family Medicine

  NPD
• Summit Medical Group PLLC

  dba Summit Medical Group of Oak Ridge

  • Family Medicine Physician
  • Oak Ridge, TN
  • NPI 1437238797
  NPD (past)
• Summit Medical Group, PLLC

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1699722470
  NPD (past)

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

• Comprehensive Home Healthcare Services LLC

  dba Amedisys Home Health Care

  • Home Health Agency
  • Morristown, TN
  • NPI 1639127319
  Care Compare affiliation
• Takoma Regional Hospital Inc

  dba Ballad Health Medical Associates

  • General Acute Care Hospital
  • Greeneville, TN
  • NPI 1699819003
  Care Compare affiliation

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1467027334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 DICK LONAS RD UNIT 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091383",
            "telephone_number": "865-584-4747",
            "fax_number": "865-381-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 TUSCULUM BLVD STE 3000",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454648",
            "telephone_number": "423-638-1188",
            "fax_number": "833-908-2068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207343",
            "country_code": "US",
            "telephone_number": "423-989-4050",
            "fax_number": "423-990-3044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "ALLI",
        "middle_name": "NICKELL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "5441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLI",
            "last_name": "NICKELL",
            "middle_name": "JOHANNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brad and Debbie Phelps Inc (Medicine Shoppe)
• Brad S. Johnson, DMD, PLLC
• Harry Bradburn, D.PH.
• Barbara Jean Bradford, APN
• Roberts Joseph Bradford Sr., DDS
• David Eugene Brannock
• Rufus G Breckenridge, M.D.
• Kenneth Grant Brewer, LPC
• William Robert Bridges, M.D.
• Bright Futures Therapy LLC

• Family Medicine Physician in Greeneville, TN
• Providers in Greeneville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.