Bradley James Shuder, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009045A Issued in IN

Practice address

549 E County Line Rd
Suite G
Greenwood, IN 46143-1067

Phone

(317) 881-9364

Fax

(317) 883-0881

NPI assigned

Aug 30, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Barbara McElhiney, DDS, PC

  • General Practice Dentistry
  • Greenwood, IN
  • NPI 1023266822
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1487764205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 E COUNTY LINE RD",
            "address_2": "SUITE G",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431067",
            "telephone_number": "317-881-9364",
            "fax_number": "317-883-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 E COUNTY LINE RD",
            "address_2": "SUITE G",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431067",
            "telephone_number": "317-881-9364",
            "fax_number": "317-883-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUDER",
        "first_name": "BRADLEY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009045A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100131310A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul E Shoemaker, RPH
• Timothy James Shoemaker, MD
• Jessie Short
• Jordan Shown, ATC, LAT
• Rachel Nicole Shuck, NP
• Celine Yun Siahmakoun, DPT
• Melissa Sue Sichting, LCSW, LCAC
• Steve Sidhom
• Harvir Sidhu
• Eleni Sidiropoulous, RBT

• General Practice Dentistry in Greenwood, IN
• Providers in Greenwood, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.