Christopher Bradley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001006280 Issued in NC

Practice address

249 Williamson Rd
Suite 101
Mooresville, NC 28117-8195

Phone

(704) 360-4564

Fax

(704) 360-4553

NPI assigned

Feb 22, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GGICCA

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.

• Carolina Pain and Weight Loss

  • Pain Medicine Physician
  • Mooresville, NC
  • NPI 1598101974
  Medicare reassignment NPD

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1790144558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 WILLIAMSON RD",
            "address_2": "SUITE 101",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178195",
            "telephone_number": "704-360-4564",
            "fax_number": "704-360-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 WILLIAMSON RD",
            "address_2": "SUITE 101",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178195",
            "telephone_number": "704-360-4564",
            "fax_number": "704-360-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-22",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001006280",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001006280",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LICENSE",
            "identifier": "0010-06280",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dennekie Boyd
• Renee Boyer, PHARMD
• Patrice Boykin
• Brian Joseph Boyle, PT,DPT
• Brian M Bradigan, LCASA
• Steven H Bradley, MD
• Christopher Brady, PHARM.D.
• Nicole Brady
• Kristen Phillips Bragg, M.S., CCC-SLP
• Amany Riberio Villa Branco

• Physician Assistant in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.