Individual provider Active NPI

Bradley Jefferson Walsh, MD

  • Family Medicine Physician
  • Crossett, AR
National Provider Identifier
1871715904
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-5429 Issued in AR
Practice address
909 Unity Rd
Crossett, AR 71635-9444
Phone
(870) 364-9111
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-5429 AR Primary

Addresses

Primary practice location

909 Unity Rd
Crossett, AR 71635-9444

Mailing address

909 Unity Rd
Crossett, AR 71635-9444
Phone (870) 364-9111

Other practice location 1

909 Unity Rd
Crossett, AR 71635-9444
Phone (870) 364-9111

Other identifiers 1

IdentifierTypeStateIssuer
176035001MedicaidAR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bradley.walsh@chfdacmc.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20090105000236 AR Practitioner - Family Practice 6507928389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crossett Health FoundationGroup PAC ID 9133030117, 23 clinicians

Practice addresses (Care Compare)

909 Unity Rd
Suite B
Crossett, AR 71635-9444
Phone (870) 364-9111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.89 of 100Reported as individual
Quality
72.11
Promoting interoperability
100
Improvement activities
40
Cost
70.84

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crossett Health Foundation CurrentSince Oct 14, 2017 Accepting new patients
Crossett Health Foundation Past Accepting new patients
Crossett Health Foundation Past Accepting new patients

Locations

909 Unity Rd
Crossett, AR 71635
Phone (870) 364-5100

1015 Unity Rd
#400
Crossett, AR 71635
Phone (870) 364-1272

909 Unity Rd
Ste B
Crossett, AR 71635
Phone (870) 364-9111

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

Interoperability endpoints

  • Direct secure messaging: bradley.walsh@chfdacmc.eclinicaldirectplus.com

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1871715904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 UNITY RD",
            "city": "CROSSETT",
            "state": "AR",
            "postal_code": "716359444",
            "telephone_number": "870-364-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 UNITY RD",
            "city": "CROSSETT",
            "state": "AR",
            "postal_code": "716359444",
            "telephone_number": "870-364-9111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 Unity Rd",
            "address_purpose": "LOCATION",
            "city": "Crossett",
            "state": "AR",
            "postal_code": "716359444",
            "country_code": "US",
            "telephone_number": "870-364-9111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "BRADLEY",
        "middle_name": "JEFFERSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2023-05-16",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-5429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176035001",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bradley.walsh@chfdacmc.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "909 Unity Rd",
            "city": "Crossett",
            "state": "AR",
            "country_code": "US",
            "postal_code": "716359444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crossett, AR

Sources for this page

Verify at the official NPI Registry.