Individual provider Active NPI

Robert H. Bradley, M.D.

  • Neurological Surgery Physician
  • Montgomery, AL
National Provider Identifier
1801998844
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
00014647 Issued in AL
Practice address
2065 E South Blvd
Suite 204
Montgomery, AL 36116-2463
Phone
(334) 281-6990
Fax
(337) 281-9725
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 00014647 AL Primary

Addresses

Primary practice location

2065 E South Blvd
Suite 204
Montgomery, AL 36116-2463

Mailing address

2065 E South Blvd
Suite 204
Montgomery, AL 36116-2463
Phone (334) 281-6990

Other identifiers 1

IdentifierTypeStateIssuer
000080959BRAMedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110118000004 AL Practitioner - Neurosurgery 6406884188 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00014647ALMDNeurological Surgery Physician
00000000ALMDNon-emergency Medical Transport (VAN)

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Dec 28, 2018 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Current Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Dec 28, 2018 Accepting new patients

Locations

2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390

2055 E South Blvd
Ste 200
Montgomery, AL 36116
Phone (334) 284-5211

2065 E South Blvd
Ste 204
Montgomery, AL 36116
Phone (334) 281-6990

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.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1801998844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2065 E SOUTH BLVD",
            "address_2": "SUITE 204",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162463",
            "telephone_number": "334-281-6990",
            "fax_number": "337-281-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2065 E SOUTH BLVD",
            "address_2": "SUITE 204",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162463",
            "telephone_number": "334-281-6990",
            "fax_number": "337-281-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "ROBERT",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AL",
            "license": "00014647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000080959BRA",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.