Individual provider Active NPI

Steven H Bradley, MD

  • Anesthesiology Physician
  • Mooresville, NC
National Provider Identifier
1669581781
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
39551 Issued in NC
Practice address
146 Medical Park Rd Ste 108
Mooresville, NC 28117
Phone
(704) 662-0877
Fax
(704) 662-0875
NPI assigned
Aug 30, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 39551 NC
Anesthesiology Physician 207L00000X 39551 NC Primary

Addresses

Primary practice location

146 Medical Park Rd Ste 108
Mooresville, NC 28117

Mailing address

146 Medical Park Rd Ste 108
Mooresville, NC 28117-8529
Phone (704) 662-0877

Other practice location 1

131 Medical Park Rd
Suite 201
Mooresville, NC 28117
Phone (704) 662-0877

Other practice location 2

131 Medical Park Rd
Suite 201
Mooresville, NC 28117
Phone (704) 662-0877

Other identifiers 2

IdentifierTypeStateIssuer
8917505MedicaidNC
17505OtherNCBCBS

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100724000218 NC Practitioner - Anesthesiology 9739174913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Louisiana State University School of Medicine in New Orleans, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Norman Anesthesia AssociatesGroup PAC ID 1951396126, 25 clinicians

Practice addresses (Care Compare)

114 Commerce Ctr Loop
Suite B
Mooresville, NC 28117-8385
Phone (704) 662-0877

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39551NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Norman Anesthesia Associates Specialist CurrentSince Jan 1, 1993 Accepting new patients

Locations

114 Commerce Center Loop
Ste B
Mooresville, NC 28117
Phone (704) 662-0877

146 Medical Park Rd
Ste 108
Mooresville, NC 28117
Phone (704) 662-0876

171 Fairview Rd
Mooresville, NC 28117
Phone (704) 660-4000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1669581781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 MEDICAL PARK RD STE 108",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178529",
            "telephone_number": "704-662-0877",
            "fax_number": "704-662-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 MEDICAL PARK RD STE 108",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-662-0877",
            "fax_number": "704-662-0875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 Medical Park Rd",
            "address_2": "SUITE 201",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "28117",
            "country_code": "US",
            "telephone_number": "704-662-0877",
            "fax_number": "704-662-0875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "131 Medical Park Rd",
            "address_2": "SUITE 201",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "28117",
            "country_code": "US",
            "telephone_number": "704-662-0877",
            "fax_number": "704-662-0875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "STEVEN",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "39551",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "39551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8917505",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "17505",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.