Robert Lee Bradford, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

002033 Issued in GA

Practice address

508 Gordon Ave
Thomasville, GA 31792-6646

Phone

(229) 226-0125

Fax

(229) 226-0195

NPI assigned

Feb 28, 2007

Last updated

Jul 9, 2013By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• 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.

• Tallahassee Ear, Nose & Throat-Head & Neck Surgery, P.a.

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  • Tallahassee, FL
  • NPI 1790797728
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1669509196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 GORDON AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926646",
            "telephone_number": "229-226-0125",
            "fax_number": "229-226-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 GORDON AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926646",
            "telephone_number": "229-226-0125",
            "fax_number": "229-226-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "ROBERT",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "002033",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA2799",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001321A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Reed Bowen, OD
• Sabrina Valeria Boykins-Everett, BS, MS, EDD
• Adam Stuart Bozeman, D.M.D,
• C. Ronnie Bozeman, DMD
• Tracy Brack, LPC
• Kaitlyn Bradley, PTGEORGIA
• Curtis Bradshaw
• Cordell Bragg, MD
• Karen Bramblett, MD
• Deborah J. Brandt, P.A.

• Medical Physician Assistant in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; 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.