Active NPI
Jeremy L Bradley, MD
- Family Medicine Physician
- Owensboro, KY
National Provider Identifier
1851483291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 31984
- Practice address
- 3122 Commonwealth CT
Owensboro, KY 42303-2258 - Phone
- (270) 684-7711
- Fax
- (270) 684-7753
- NPI assigned
- Sep 29, 2006
- Last updated
- Feb 28, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 31984 | KY | Primary |
Addresses
Primary practice location
3122 Commonwealth CT
Owensboro, KY 42303-2258
Mailing address
3122 Commonwealth CT
Owensboro, KY 42303-2258
Phone (270) 684-7711
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64319841 | Medicaid | KY | |
| 000000075315 | Other | KY | BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070509000566 | KY | Practitioner - Family Practice | 9537265491 | Practice locations: Owensboro, KY |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Kentucky College of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Owensboro Health, Inc
Practice addresses (Care Compare)
1006 Ford Ave
Owensboro, KY 42301-4677
Phone (270) 688-4845
3122 Commonwealth Court
Owensboro, KY 42303-2258
3122 Commonwealth CT
Owensboro, KY 42303-2258
Phone (270) 684-7711
Hospital & facility affiliations
- Owensboro Health Home Care
- Family Home Health Care, LLC Dba Adoration Home Health
- Caresouth HHA Holdings of Winchester, LLC Dba Enhabit Home Health
- Caretenders
- Hospice of Western Kentucky
- Owensboro Health Regional Hospital
- Ohio County Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31984 | KY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeremy Bradley MD PSC | Family Medicine | Past | Accepting new patients |
| Kentucky Physicians Services, LLC | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GGJBCD/Endpoint/GGJBCD
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Owensboro, KY
- NPI 1215208608
-
- Family Medicine Physician
- Lexington, KY
- NPI 1750693297
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Enhabit Home Health
- Home Health Agency
- Owensboro, KY
- NPI 1902341399
-
dba Adoration Home Health
- Home Health Agency
- Owensboro, KY
- NPI 1285604140
-
dba Hospice of Western Kentucky
- Community Based Hospice Care Agency
- Owensboro, KY
- NPI 1003892977
-
- Critical Access Hospital
- Hartford, KY
- NPI 1629007430
-
dba Owensboro Health Regional Hospital
- General Acute Care Hospital
- Owensboro, KY
- NPI 1285613612
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709078400000",
"number": "1851483291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3122 COMMONWEALTH CT",
"city": "OWENSBORO",
"state": "KY",
"postal_code": "423032258",
"telephone_number": "270-684-7711",
"fax_number": "270-684-7753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3122 COMMONWEALTH CT",
"city": "OWENSBORO",
"state": "KY",
"postal_code": "423032258",
"telephone_number": "270-684-7711",
"fax_number": "270-684-7753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "JEREMY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2024-02-28",
"certification_date": "2024-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "31984",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64319841",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "000000075315",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Owensboro, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.