Ian Bradley

Primary specialty

PharmacistTaxonomy code 183500000X

License

100142 Issued in TN

Practice address

1000 S Main St
Springfield, TN 37172-3508

Phone

(615) 384-3546

NPI assigned

Aug 19, 2017

Last updated

Mar 17, 2018By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• South Side Pharmacy, Inc.

  dba South Side Drug Co., INC.

  • Long Term Care Pharmacy
  • Springfield, TN
  • NPI 1548911498
  Authorized official Same address or phone

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

{
    "created_epoch": "1503100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1952827115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SOUTH MAIN STREET",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "37172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S MAIN ST",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371723508",
            "telephone_number": "615-384-3546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Connell St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "TN",
            "postal_code": "371722348",
            "country_code": "US",
            "telephone_number": "615-533-9007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "IAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "100142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crista L Bess, COTA/L
• Kim Bibb
• Catherine Bixby, MSN, RN, APRN, NP-C
• Sarah Blair
• Billy Gene Bowie, PHD
• Melissa F. Bradley, RN
• Michelle Marie Breedlove, APN
• Sierra Dorris Bridgers, APRN
• Tamica Lashawn Britton
• Jeremiah Brown

• Pharmacist in Springfield, TN
• Providers in Springfield, TN by specialty
• Pharmacist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.