Bradley John Kinney, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD.MD.61283530 Issued in WA

Practice address

901 Mountain View Dr
Shelton, WA 98584-4401

Phone

(360) 427-9595

NPI assigned

Jan 20, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in GU, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Guam Healthcare Development Incorporated

  • Clinic/Center
  • Dededo, GU
  • NPI 1326447939
  Medicare reassignment NPD
• SGMC Affiliated Services LLC

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1114740362
  Medicare reassignment NPD
• South Georgia Emergency Medicine Associates PC

  • Emergency Medicine Physician
  • Thomasville, GA
  • NPI 1386903649
  Medicare reassignment NPD
• SGMC Physician Network Inc

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1417597170

  Emergency Medicine

  NPD

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716681600000",
    "number": "1851662936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MOUNTAIN VIEW DR",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MOUNTAIN VIEW DR",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844401",
            "telephone_number": "360-427-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "BRADLEY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-20",
        "last_updated": "2024-05-26",
        "certification_date": "2024-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD.MD.61283530",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "99621",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101254504",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GU",
            "license": "M-2187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Kiliona, L. AC.
• Franz M Kilmer-Shoultz
• Kelly Gale Kimbel, LMHC
• Natalya Kinder, CDPT
• Tammy Kindle, CDPT
• Rayleen Denise Kirkland, PAC
• Elizabeth Klaniecki, RDH
• Melinda Carol Kleppen, LMP
• Meteja Klukas
• Misty Knight, LMP

• Emergency Medicine Physician in Shelton, WA
• Providers in Shelton, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.