Individual provider Active NPI

Bradley Daily Harris, MD

  • Pediatrics Physician
  • Scottsboro, AL
National Provider Identifier
1487282448
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
46753 Issued in AL
Practice address
23800 John T Reid Pkwy
Scottsboro, AL 35768-2841
Phone
(256) 999-0808
Fax
(844) 490-5876
NPI assigned
Mar 27, 2020
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 46753 AL Primary

Addresses

Primary practice location

23800 John T Reid Pkwy
Scottsboro, AL 35768-2841

Mailing address

3008 Blue Ridge Dr W
Mobile, AL 36693-3333
Phone (251) 599-7976

Other practice location 1

1359 Old Water Works Rd SW
Fort Payne, AL 35968-3347
Phone (256) 997-5900

Other practice location 2

657 Trojan Pkwy
Troy, AL 36079-0002
Phone (334) 934-5437

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200708000355 NC Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7012330178

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46753ALMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kids 1St Pediatrics, LLC Pediatrics CurrentSince Jul 23, 2023 Accepting new patients
Trojan Pediatrics, LLC Pediatrics PastSince May 1, 2023 Accepting new patients
Coastal Pediatrics LLC Pediatrics PastSince Feb 11, 2024 Accepting new patients

Locations

1359 Old Water Works Rd SW
Fort Payne, AL 35968
Phone (256) 997-5900

23800 John T Reid Pkwy
Scottsboro, AL 35768
Phone (256) 997-5900

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19886/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1487282448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 BLUE RIDGE DR W",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933333",
            "telephone_number": "251-599-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23800 JOHN T REID PKWY",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357682841",
            "telephone_number": "256-999-0808",
            "fax_number": "844-490-5876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1359 Old Water Works Rd SW",
            "address_purpose": "LOCATION",
            "city": "Fort Payne",
            "state": "AL",
            "postal_code": "359683347",
            "country_code": "US",
            "telephone_number": "256-997-5900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "657 Trojan Pkwy",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "AL",
            "postal_code": "360790002",
            "country_code": "US",
            "telephone_number": "334-934-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "BRADLEY",
        "middle_name": "DAILY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "46753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsboro, AL

Sources for this page

Verify at the official NPI Registry.