Bradley S Thompson Family Limited Partnership No One
Organization Active NPI Chiropractor · Southaven, MS
NPI 1720106875 · NPPES record last updated Jun 24, 2014
Key facts
- NPI
- 1720106875
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- BRADLEY S THOMPSON FAMILY LIMITED PARTNERSHIP NO ONE
- Practice address
- 7464 Tchulahoma Road
Southaven, MS 38671 - Phone
- (662) 349-4494
- Fax
- (662) 349-4495
- NPI assigned
- Mar 27, 2007
- Organization subpart
- No
Authorized official
- Name
- Bradley S Thompson, DC
- Title
- Doctor Owner
- Phone
- (662) 349-4494
Practitioners 2
-
Bradley Thompson, D.C.
-
Mary Karen Martin, B.S., D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080125000182 | MS | Part B Supplier - Clinic/Group Practice | 2860574167 |
Receives reassigned benefits from 1 practitioner Practice locations: Southaven, MS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
7464 Tchulahoma Road
Southaven, MS 38671
Mailing address
PO Box 225
Southaven, MS 38671
Phone (662) 349-4494
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 350044428 | Other | MS | RR MEDICARE |
| 3045182 | Other | TN | BCBS |
Other names
- Bradley S Thompson Chiropractic
Other providers in Southaven, MS
- Kelsey Boyd
- Tiffany Boyd
- Wesley Boyd
- Jarad Joseph Braddy
- John Mark Bradford
- Mackenzie Eryn Brannan
- Gina Vick Bray
- Samuel Breite
- William E. Brent
- Herbert Leon Brewer III
All providers in Southaven, MS · Chiropractor in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2014. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.