Active NPI
Adrienne W Bradley, MD
- Internal Medicine Physician
- Beverly, MA
National Provider Identifier
1548295702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 71896
- Practice address
- 77 Herrick St
Medical Group Inc Ste 101
Beverly, MA 01915-3012 - Phone
- (978) 927-4110
- Fax
- (978) 232-7057
- NPI assigned
- Jul 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 71896 | MA | Primary |
Addresses
Primary practice location
77 Herrick St
Medical Group Inc Ste 101
Beverly, MA 01915-3012
Mailing address
77 Herrick St
Ste 101
Beverly, MA 01915-3012
Phone (978) 927-4110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3056333 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Group, Inc., the | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Beverly, MA
- NPI 1407862048
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379980800000",
"number": "1548295702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 HERRICK ST",
"address_2": "STE 101",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019153012",
"telephone_number": "978-927-4110",
"fax_number": "978-232-7057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 HERRICK ST",
"address_2": "MEDICAL GROUP INC STE 101",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019153012",
"telephone_number": "978-927-4110",
"fax_number": "978-232-7057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "ADRIENNE",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2013-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "71896",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3056333",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beverly, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.