Individual provider Active NPI

Bradley Dale Reeder, ACNP

  • Acute Care Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1780927186
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
18226 Issued in SC
Practice address
890 W Faris Rd Ste 580
Greenville, SC 29605-4281
Phone
(864) 455-7874
Fax
(864) 455-8933
NPI assigned
Apr 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 18226 SC Primary

Addresses

Primary practice location

890 W Faris Rd Ste 580
Greenville, SC 29605-4281

Mailing address

1 Independence PT
Suite 212
Greenville, SC 29615-4545
Phone (864) 797-6306

Other identifiers 1

IdentifierTypeStateIssuer
NP2374MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130716000236 SC Practitioner - Nurse Practitioner 9335389394 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

200 Fleetwood Dr
Easley, SC 29640-2022
Phone (864) 442-7618

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

701 Grove Rd
Greenville, SC 29605-4210

Hospital & facility affiliations

  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
18226SCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health-Upstate Current Accepting new patients
Prisma Health-Upstate CurrentSince Oct 1, 2016 Accepting new patients
Prisma Health University Medical Group CurrentSince Oct 1, 2017 Accepting new patients
Prisma Health University Medical Group CurrentSince Oct 1, 2017 Accepting new patients
Prisma Health-Upstate CurrentSince Oct 1, 2016 Accepting new patients

Locations

2400 Boiling Springs Rd
Ste A
Boiling Springs, SC 29316
Phone (864) 599-0731

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

11402 Anderson Rd
Ste A
Greenville, SC 29611
Phone (864) 631-2799

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

1025 Verdae Blvd
Ste B
Greenville, SC 29607
Phone (864) 240-8101

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

890 W Faris Rd
Ste 580
Greenville, SC 29605
Phone (864) 455-7874

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550

830 S Buncombe Rd
Greer, SC 29650
Phone (864) 797-8000

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

729 SE Main St
Simpsonville, SC 29681
Phone (864) 271-8647

300 Scuffletown Rd
Simpsonville, SC 29681
Phone (864) 329-0029

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Interoperability endpoints

  • Direct secure messaging: breeder33625@direct.ghs.myhfn.org

Organizations & group practices 6

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 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1780927186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154545",
            "telephone_number": "864-797-6306",
            "fax_number": "864-797-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 W FARIS RD STE 580",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054281",
            "telephone_number": "864-455-7874",
            "fax_number": "864-455-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDER",
        "first_name": "BRADLEY",
        "middle_name": "DALE",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "18226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2374",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.