NPIMap

Individual provider Active NPI

Thomas Lane Bradbury Jr., MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Atlanta, GA
National Provider Identifier
1720019698
Registry record updated Feb 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
059130 Issued in GA
Practice address
59 Executive Park S
Atlanta, GA 30329-2208
Phone
(404) 778-7188
Fax
(404) 778-7036
NPI assigned
Jul 6, 2006
Last updated
Feb 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 200600296 NC
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 059130 GA Primary

Addresses

Primary practice location

59 Executive Park S
Atlanta, GA 30329-2208

Mailing address

59 Executive Park S
Atlanta, GA 30329-2208
Phone (404) 778-7188

Other identifiers 1

IdentifierTypeStateIssuer
5904146MedicaidNC

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
I20070809000057 GA Practitioner - Orthopedic Surgery 6901809987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Medical College of Georgia School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Joint Surgery Specialists, LLCGroup PAC ID 2961795190, 46 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

2000 Howard Farm Dr
Suite 200
Cumming, GA 30041-6081
Phone (770) 667-4337

5513 Chamblee Dunwoody Rd
Dunwoody, GA 30338-4106
Phone (770) 551-9633

655 Molly LN
Woodstock, GA 30189-6519
Phone (770) 517-1080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.29 of 100Reported as group
Quality
67.84
Promoting interoperability
73
Improvement activities
40
Cost
85.62

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement176
Knee replacement187

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200600296NCMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Joint Surgery Specialists, LLC CurrentSince Sep 1, 2022 Accepting new patients
Northside Surgical Professional Services LLC Past Accepting new patients
Advanced Center for Joint Replacement Gwinnett, LLC PastSince Sep 4, 2024 Accepting new patients

Locations

3400 Old Milton Pkwy
Ste 290
Alpharetta, GA 30005
Phone (770) 667-4343

3400 Old Milton Pkwy
Ste C290
Alpharetta, GA 30005
Phone (770) 667-4337

2000 Howard Farm Dr
Ste 200
Cumming, GA 30041
Phone (770) 667-4337

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1150 Hammond Dr
Ste 400
Sandy Springs, GA 30328
Phone (404) 234-2753

Interoperability endpoints

  • Direct secure messaging: tbradbury21699@direct.emory.org
  • Direct secure messaging: tbradbury46405@choa.gadirect.net

Organizations & group practices 3

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 8

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422748800000",
    "number": "1720019698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 EXECUTIVE PARK S",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292208",
            "telephone_number": "404-778-7188",
            "fax_number": "404-778-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 EXECUTIVE PARK S",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292208",
            "telephone_number": "404-778-7188",
            "fax_number": "404-778-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBURY",
        "first_name": "THOMAS",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2015-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NC",
            "license": "200600296",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "GA",
            "license": "059130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904146",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.