Active NPI
Bradley J Robottom, MD
- Neurology Physician
- Durham, NC
National Provider Identifier
1558486688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- D68380
- Practice address
- 4111 Ben Franklin Blvd
Durham, NC 27704-2141 - Phone
- (919) 719-8834
- Fax
- (919) 582-0528
- NPI assigned
- Mar 20, 2007
- Last updated
- Aug 3, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | D68380 | MD | Primary |
Addresses
Primary practice location
4111 Ben Franklin Blvd
Durham, NC 27704-2141
Mailing address
1540 Sunday Dr
Raleigh, NC 27607-6010
Phone (919) 782-3456
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D68380 | Other | MD | MEDICAL LICENSE |
| 2011-00566 | Other | NC | NC LICENSE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Medical University of South Carolina College of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1540 Sunday Dr
Raleigh, NC 27607-6000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 85 of 100
- Quality
- 65.93
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 84.07
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D68380 | MD | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raleigh Neurology Associates, P. a. | Neurology | Current | Accepting new patients |
| Rex Hospital, Inc. | Past | Accepting new patients |
Locations
4111 Ben Franklin Blvd
Durham, NC 27704
Phone (919) 782-3456
1540 Sunday Dr
Raleigh, NC 27607
Phone (919) 782-3456
Interoperability endpoints
- bradley.robottom.1@25810.direct.athenahealth.com
- https://api.platform.athenahealth.com/25810/brand/1/csg/1/fhir/r4
Organizations & group practices 2
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.
-
- Neurology Physician
- Raleigh, NC
- NPI 1215954003
-
dba Rex Nutrition Services
- Nutrition Education Nutritionist
- Raleigh, NC
- NPI 1821472572
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba WakeMed Mental Health & Well-Being Hospital WakeBrook
- Psychiatric Hospital Unit
- Raleigh, NC
- NPI 1780446302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312329600000",
"number": "1558486688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1540 SUNDAY DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276076010",
"telephone_number": "919-782-3456",
"fax_number": "919-783-1441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4111 BEN FRANKLIN BLVD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277042141",
"telephone_number": "919-719-8834",
"fax_number": "919-582-0528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBOTTOM",
"first_name": "BRADLEY",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2011-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MD",
"license": "D68380",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "D68380",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC LICENSE",
"identifier": "2011-00566",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; 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.