Thomas A Bradley, APRN
Individual provider Active NPI Family Nurse Practitioner · Greenbrier, AR
NPI 1659935476 · NPPES record last updated Feb 8, 2020
Key facts
- NPI
- 1659935476
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- A006073 (AR)
- Practice address
- 20 Wilson Farm Rd
Greenbrier, AR 72058 - Phone
- (870) 895-2015
- Fax
- (870) 895-2164
- NPI assigned
- Apr 26, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Appello Health and Wellness Clinic LLC
Practice addresses (Care Compare)
2223 Grant St
Malvern, AR 72104-4700
Phone (501) 337-9031
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190603002610 | AR | Practitioner - Nurse Practitioner | 9234462458 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A006073 | AR | Yes |
Addresses
Primary practice location
20 Wilson Farm Rd
Greenbrier, AR 72058
Mailing address
101 W Main St
Hardy, AR 72542-9566
Other practice location 1
942 Highway 65 N
Marshall, AR 72650-7772
Phone (888) 518-1418
Other practice location 2
106 Highway 62 W
Salem, AR 72576-8059
Phone (870) 895-2015
Other providers in Greenbrier, AR
- Misty L Birdwell
- Ginger Blacksmith
- Lauren Blansett
- Savanna Nicole Boone
- Gary Wayne Bowman
- Kristina Marie Brazeal
- Christie M. Brewer
- Amesha Brewies
- Kara Michelle Brooks
- Broom Chiropractic and Sports Therapy
All providers in Greenbrier, AR · Family Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.