NPIMap

Individual provider Active NPI

Bradley Jay Stokes, D.O.

  • Family Medicine Physician
  • Georgetown, OH
National Provider Identifier
1740627488
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0061641 Issued in CO
Practice address
631 E State St
Georgetown, OH 45121-1437
Phone
(937) 378-6387
Fax
(937) 378-4253
NPI assigned
Jun 3, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X DR.0061641 CO Primary
Family Medicine Physician 207Q00000X 34.011946 OH

Addresses

Primary practice location

631 E State St
Georgetown, OH 45121-1437

Mailing address

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917-5152
Phone (513) 576-7700

Other identifiers 1

IdentifierTypeStateIssuer
0121057MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20190204002529 CO Practitioner - Family Practice 9739408840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Vista Community Health CentersGroup PAC ID 4688583974, 126 clinicians

Practice addresses (Care Compare)

1400 E Boulder
Colorado Springs, CO 80909-5533
Phone (719) 776-5000

1815 Jet Wing Dr
Colorado Springs, CO 80916-2300
Phone (719) 632-5700

255 S Union Blvd
Union Family Health
Colorado Springs, CO 80910-3124
Phone (719) 630-6440

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers Single Specialty CurrentSince Dec 19, 2018 Accepting new patients
Peak Vista Community Health Centers CurrentSince Dec 19, 2018 Accepting new patients
Peak Vista Community Health Centers Past Accepting new patients

Locations

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

1815 Jet Wing Dr
Colorado Springs, CO 80916
Phone (719) 344-6331

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

Interoperability endpoints

  • Direct secure messaging: bradley.stokes.p1@direct.peakvista.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1740627488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD",
            "address_2": "STE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175152",
            "telephone_number": "513-576-7700",
            "fax_number": "513-707-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 E STATE ST",
            "city": "GEORGETOWN",
            "state": "OH",
            "postal_code": "451211437",
            "telephone_number": "937-378-6387",
            "fax_number": "937-378-4253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOKES",
        "first_name": "BRADLEY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-03",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0061641",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.011946",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0121057",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, OH

Sources for this page

Verify at the official NPI Registry.