James Keith Bradley – Pulmonary Disease Physician

Key facts

NPI: 1689640229
Entity type: Individual (NPI type 1)
Primary specialty: Pulmonary Disease Physician 207RP1001X
License: 04-18815 (KS)
Practice address: 20375 W 151St St
Suite 451
Olathe, KS 66061-7218
Phone: (913) 829-0446
Fax: (913) 829-7829
NPI assigned: Feb 24, 2006
Sex: Male
Sole proprietor: No

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 and National Provider Directory roles.

Olathe Health Physicians, Inc. Family Medicine Physician · Olathe, KS · NPI 1598784639

Medicare reassignment KS

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Cedar Lake Village, Inc Skilled Nursing Facility · Olathe, KS · NPI 1255345427

CMS ownership CORPORATE DIRECTOR

Medicare participation

Medicare fee-for-service enrollment: Enrolled in KS
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Facility	Type	Role	Since
Hoeger House Olathe, KS · CCN 175491	Skilled nursing facility	Corporate Director	Nov 20, 1998

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20050607000996	KS	Practitioner - Pulmonary Disease Practitioner - Internal Medicine Practitioner - Critical Care (Intensivists)	5597759241	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
04-18815	KS	MD	Pulmonary Disease Physician

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pulmonary Disease Physician	207RP1001X	04-18815	KS	Yes

Addresses

Primary practice location

20375 W 151St St
Suite 451
Olathe, KS 66061-7218

Mailing address

20375 W 151St St
Suite 451
Olathe, KS 66061-7218
Phone (913) 829-0446

Other identifiers

Identifier	Type	State	Issuer
100198850A	Medicaid	KS

Other providers in Olathe, KS

All providers in Olathe, KS · Pulmonary Disease Physician in Kansas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2011. 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.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.