Austin Bradley, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209013889 Issued in IL

Practice address

405 W Jackson St
Carbondale, IL 62901-1462

Phone

(618) 549-0721

NPI assigned

Feb 24, 2016

Last updated

Apr 2, 2016By 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 IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Southern Orthopedic Associates SCGroup PAC ID 8921095514, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Herrin Hospital Hospital, Herrin, IL, CCN 140011
• Harrisburg Medical Center Hospital, Harrisburg, IL, CCN 140210
• Heartland Regional Medical Center Hospital, Marion, IL, CCN 140184
• Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abradley7446@sih.direct-ci.com
• Direct secure messaging: abradley825645@direct.deaconess.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Southern Orthopedic Associates SC

  • Orthopaedic Surgery Physician
  • Herrin, IL
  • NPI 1396792412
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Deaconess Regional Healthcare Services Illinois Inc

  dba Deaconess Illinois Medical Center

  • General Acute Care Hospital
  • Marion, IL
  • NPI 1750007266
  Care Compare affiliation
• Harrisburg Medical Center Inc

  • General Acute Care Hospital
  • Harrisburg, IL
  • NPI 1073580130
  Care Compare affiliation
• Southern Illinois Hospital Services

  dba Memorial Hospital of Carbondale

  • General Acute Care Hospital
  • Carbondale, IL
  • NPI 1093801797
  Care Compare affiliation
• Southern Illinois Hospital Services

  dba Herrin Hospital

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Care Compare affiliation

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459555200000",
    "number": "1649630294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011462",
            "telephone_number": "618-549-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011462",
            "telephone_number": "618-549-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "AUSTIN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-24",
        "last_updated": "2016-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia A Boudet, PA
• Elizabeth A Bowen, RN, ACCNS-AG
• Amanda J Bowers, FNP
• Annamaria Boyce, CRNA
• Brad McMillin, Inc (Beltone Hearing Aid Service)
• Datrese Monique Bradley, LCPC
• Mary L Brandenburg, PA
• Debra Lynn Braunling McMorrow, PHD
• Brian G. McElheny, M.D. LTD
• Brigham Anesthesia South LLC

• Family Nurse Practitioner in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2016; 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.