NPIMap

Individual provider Active NPI

David Brandon Bradley, PA

  • Physician Assistant
  • Macon, GA
National Provider Identifier
1710221841
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6664 Issued in GA
Practice address
310 Hospital Dr Ste 330
Macon, GA 31217-3895
Phone
(478) 200-8152
NPI assigned
Nov 15, 2012
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6664 GA Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 6664 GA

Addresses

Primary practice location

310 Hospital Dr Ste 330
Macon, GA 31217-3895

Mailing address

4433 Johnstonville Rd
Forsyth, GA 31029-4925

Other practice location 1

840 Pine St Ste 750
Macon, GA 31201-7528
Phone (478) 633-1458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130626000940 GA Practitioner - Physician Assistant 4385883131 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

150 Eagle Spring CT
Suite a
Stockbridge, GA 30281-6330
Phone (470) 852-2301

22 Piedmont Ave SE
3Rd Floor
Atlanta, GA 30303-3050
Phone (404) 616-2215

350 Hospital Dr
Macon, GA 31217-3838
Phone (478) 765-7000

380 Hospital Dr
Suite 460
Macon, GA 31217-8001
Phone (478) 200-8152

56 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3050
Phone (404) 616-8880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Nov 1, 2021 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Nov 1, 2021 Accepting new patients
Acute Care Surgery Medical Group, Inc. CurrentSince Oct 15, 2025 Accepting new patients
Mayo Clinic Health System in Waycross, Inc. Past Accepting new patients
Privia Medical Group of Georgia LLC Past Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

150 Eagle Spring Ct
Ste A
Stockbridge, GA 30281
Phone (404) 299-3338

Organizations & group practices 9

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 3

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": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1710221841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4433 JOHNSTONVILLE RD",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310294925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HOSPITAL DR STE 330",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173895",
            "telephone_number": "478-200-8152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 Pine St Ste 750",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312017528",
            "country_code": "US",
            "telephone_number": "478-633-1458",
            "fax_number": "478-633-5025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "DAVID",
        "middle_name": "BRANDON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6664",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "GA",
            "license": "6664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.