Andrew Bradbury, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3187 Issued in TN

Practice address

120 Reynolda VLG Ste B
Winston Salem, NC 27106-5144

Phone

(336) 701-6460

Fax

(336) 701-6465

NPI assigned

Aug 4, 2014

Last updated

Aug 13, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrew.bradbury@direct.revolutionehr.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.

• A Proper View OD PLLC

  • Optometrist
  • Winston Salem, NC
  • NPI 1124526835
  Medicare reassignment NPD Authorized official
• Carolina Center for Eye Care, OD PA

  • Optometrist
  • Advance, NC
  • NPI 1528141009
  Medicare reassignment NPD

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1487063400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 REYNOLDA VLG STE B",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065144",
            "telephone_number": "336-701-6460",
            "fax_number": "336-701-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 REYNOLDA VLG STE B",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065144",
            "telephone_number": "336-701-6460",
            "fax_number": "336-701-6465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5380 US Highway 158 Ste 100",
            "address_purpose": "LOCATION",
            "city": "Advance",
            "state": "NC",
            "postal_code": "270066974",
            "country_code": "US",
            "telephone_number": "336-940-2015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADBURY",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-04",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Ann Bozylinsky, PA-C
• Tanya Brabham
• Christina Bracken
• Christy Tucker Bracken, PA-C
• Cole Bradburn
• Laura Bradford
• Lauren Bradford, MD
• Natalie Steele Bradford, M.D.
• Amanda Bradley, RPH
• Faith Victoria Bradley

• Optometrist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; 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.