Individual provider Active NPI

Bradly C. Newcom, M.D.

  • Pain Medicine Physician
  • Madisonville, KY
National Provider Identifier
1912004649
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
39210 Issued in KY
Practice address
510 Ruby Dr
Madisonville, KY 42431-2168
Phone
(270) 399-7900
Fax
(270) 399-7910
NPI assigned
Sep 17, 2006
Last updated
May 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 39210 KY
Pain Medicine Physician 208VP0000X 39210 KY Primary

Addresses

Primary practice location

510 Ruby Dr
Madisonville, KY 42431-2168

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other practice location 1

200 Clinic Dr
Madisonville, KY 42431-1661
Phone (270) 825-7330

Other identifiers 3

IdentifierTypeStateIssuer
39210OtherKYLICENSE
000000362048OtherBCBS PROVIDER NUMBER
64098379MedicaidKY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bnewcom41501@direct.owensborohealth.org
Direct Messaging Address bnewcom41501@direct.owensborohealth.org

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050504000887 KY Practitioner - AnesthesiologyPractitioner - Pain Management 9739129289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
University of Kentucky College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2211 Mayfair Dr
Owensboro, KY 42301-4569

440 Hopkinsville St
Greenville, KY 42345-1124
Phone (270) 338-8000

510 Ruby Dr
Madisonville, KY 42431-2168
Phone (270) 399-7900

PO Box
Suite 23229
Owensboro, KY 42304-3229

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39210KYMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Jan 15, 2018 Accepting new patients
Owensboro Health Medical Group, Inc. CurrentSince Jan 15, 2018 Accepting new patients
Owensboro Health Medical Group, Inc Past Accepting new patients

Locations

510 Ruby Dr
Madisonville, KY 42431
Phone (270) 399-7757

900 Hospital Dr
Madisonville, KY 42431
Phone (270) 326-3900

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

Interoperability endpoints

  • Direct secure messaging: bnewcom41501@direct.owensborohealth.org

Organizations & group practices 4

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.

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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1912004649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 RUBY DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424312168",
            "telephone_number": "270-399-7900",
            "fax_number": "270-399-7910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Clinic Dr",
            "address_purpose": "LOCATION",
            "city": "Madisonville",
            "state": "KY",
            "postal_code": "424311661",
            "country_code": "US",
            "telephone_number": "270-825-7330",
            "fax_number": "270-825-7333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWCOM",
        "first_name": "BRADLY",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "39210",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "KY",
            "license": "39210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "39210",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "000000362048",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64098379",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bnewcom41501@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "200 Clinic Dr",
            "city": "Madisonville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "424311661",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bnewcom41501@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "510 Ruby Dr",
            "city": "Madisonville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "424312168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madisonville, KY

Sources for this page

Verify at the official NPI Registry.