Timothy P Bradley, M.D.

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

16153 Issued in NH

Practice address

1 Elliot Way
Elliot Emergency Medicine
Manchester, NH 03103-3502

Phone

(603) 336-2830

Fax

(603) 663-1849

NPI assigned

Oct 9, 2007

Last updated

Jun 13, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elliot Professional Services

  • Internal Medicine Physician
  • Manchester, NH
  • NPI 1285627935
  Medicare reassignment NPD

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1922296433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY",
            "address_2": "ELLIOT EMERGENCY MEDICINE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033502",
            "telephone_number": "603-336-2830",
            "fax_number": "603-663-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY",
            "address_2": "ELLIOT EMERGENCY MEDICINE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033502",
            "telephone_number": "603-336-2830",
            "fax_number": "603-663-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "TIMOTHY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-09",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "010247477",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NH",
            "license": "16153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Catherine Braconi, LICSW
• Annetta De'Sha Bradley
• Christine L Bradley, OTR
• Michael Bradley, LCMHC, MLADC
• Stephanie Bradley, APRN
• Kim C Brady, APRN
• Loretta Lynn Carle Brady, PH.D.
• Christopher Cabral Braga, M.D.
• Melissa Rachel Brahms, LICSW
• Brainergize LLC

• Pediatric Emergency Medicine (Pediatrics) Physician in Manchester, NH
• Providers in Manchester, NH by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.