Rickey Lee Bradley, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1741 Issued in WV

Practice address

4130 Robert C Byrd Dr
Beckley, WV 25801-2206

Phone

(304) 252-3900

Fax

(304) 252-9311

NPI assigned

Oct 31, 2005

Last updated

Nov 6, 2015By 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 WV

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

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Greenbrier Emergency Services, Inc.

  • Emergency Medicine Physician
  • Gassaway, WV
  • NPI 1568401461
  Medicare reassignment NPD
• Princeton Community Hospital Assn Inc.

  dba Mercer Medical Group

  • Urology Physician
  • Princeton, WV
  • NPI 1093917643
  NPD
• Princeton Community Hospital Assn., Inc

  dba Bluefield Internal Medicine

  • Rural Health Clinic/Center
  • Bluefield, VA
  • NPI 1235446485
  NPD
• Brackenrich Family Practice, PLC

  • Family Medicine Physician
  • Rich Creek, VA
  • NPI 1235229576
  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1700877735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 ROBERT C BYRD DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258012206",
            "telephone_number": "304-252-3900",
            "fax_number": "304-252-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 ROBERT C BYRD DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258012206",
            "telephone_number": "304-252-3900",
            "fax_number": "304-252-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "RICKEY",
        "middle_name": "LEE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1741",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "1741",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005642949",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Nichole Bradbury
• Jennifer Dawn Bradford, APRN-CNP
• Erica Layne Bradley, LPC, LMT
• Jillian Bradley, C.O.T.A.
• Mildred F Bradley
• Summer Bradley
• Tameika Bradley
• Cordelia Bragg
• Diana Darlene Bragg
• Haley Nicole Bragg

• Family Medicine Physician in Beckley, WV
• Providers in Beckley, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; 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.