Bradley G Titus, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD00024594 Issued in WA

Practice address

1775 Thompson Rd
Coos Bay, OR 97420-2125

Phone

(541) 269-8111

NPI assigned

Aug 17, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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.

• Bama Heart Doc, P.C.

  dba Alabama Heart and Vascular Medicine

  • Interventional Cardiology Physician
  • Tuscaloosa, AL
  • NPI 1790057420
  Medicare reassignment NPD
• The DCH Healthcare Authority

  dba DCH Regional Medical Center

  • General Acute Care Hospital
  • Tuscaloosa, AL
  • NPI 1841394418
  Medicare reassignment NPD
• The DCH Health Care Authority

  dba DCH Health & Wellness Clinic

  • Clinic/Center
  • Tuscaloosa, AL
  • NPI 1306613211
  NPD
• Wwu Campus Health & Wellness

  • Student Health Clinic/Center
  • College Place, WA
  • NPI 1629048848
  NPD (past)

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1962494757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1398",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993620309",
            "telephone_number": "509-527-8154",
            "fax_number": "509-527-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202125",
            "telephone_number": "541-269-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Southpoint Ln",
            "address_purpose": "LOCATION",
            "city": "Walla Walla",
            "state": "WA",
            "postal_code": "993624175",
            "country_code": "US",
            "telephone_number": "509-527-8154",
            "fax_number": "509-527-8010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TITUS",
        "first_name": "BRADLEY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WA",
            "license": "MD00024594",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00024594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2012756",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Therapeutic Innovations, LLC
• Ndeye Thiaw
• Heather Thoma, RN, QMHP
• Three Branches Clinic PC
• Mark B Titcomb, CRNA
• Diane H Todd, ACNP
• Charles H Toledo, M.D.
• Michael Anthony Torres, MD, MBA
• Josephine Dela Cruz Torresani, R.D.,L.D.
• Alex Quang Tran, PHARMD

• Cardiovascular Disease Physician in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Cardiovascular Disease Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.