Tabetha Hale Bradley, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD60274491 Issued in WA

Practice address

503 E Highland Ave
Chelan, WA 98816-8631

Phone

(509) 682-8517

Fax

(509) 682-9614

NPI assigned

Jun 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tabetha Marie Hale Former name

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Chelan County Public Hospital District No 2

  • Critical Access Hospital
  • Chelan, WA
  • NPI 1578568853
  Medicare reassignment NPD
• Chelan County Public Hospital District No 2

  • Rural Health Clinic/Center
  • Chelan, WA
  • NPI 1124438312
  NPD

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1861695512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 E HIGHLAND AVE",
            "city": "CHELAN",
            "state": "WA",
            "postal_code": "988168631",
            "telephone_number": "509-682-8517",
            "fax_number": "509-682-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 E HIGHLAND AVE",
            "city": "CHELAN",
            "state": "WA",
            "postal_code": "988168631",
            "telephone_number": "509-682-8517",
            "fax_number": "509-682-9614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "TABETHA",
        "middle_name": "HALE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-08",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60274491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020730",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TABETHA",
            "last_name": "HALE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Surgery Physician in Chelan, WA
• Providers in Chelan, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; 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.