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DR. JESSE H. BRADLEY D.P.M. NPI 1114160389


NPI Information

NPI: 1114160389
Provider Name: DR. JESSE H. BRADLEY, D.P.M.
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

PECOS Registration: Yes

Address:
116 W TYLER AVE
SUITE B
WEST MEMPHIS, AR
ZIP 72301
Phone: (870) 733-0888
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DR. Jesse H. Bradley, D.P.M. is a foot and ankle surgery podiatrist in West Memphis, AR with 18 years of experience. DR. Jesse H. Bradley, D.P.M. NPI is 1114160389. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduation Year:2006

The provider's business location address is:

116 W TYLER AVE
SUITE B
WEST MEMPHIS, AR
ZIP 72301-221
Phone: (870) 733-0888
Fax: (870) 733-0889

The NPI 1114160389 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of tissue from 6 or more finger or toe nails (HCPCS:11721)
  • Removal of tissue from 1 to 5 finger or toe nails (HCPCS:11720)
  • Removal of skin and tissue first 20 sq cm or less (HCPCS:11042)
  • Removal of tissue from wounds per session (HCPCS:97597)
  • Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)
  • Removal of 2 to 4 thickened skin growths (HCPCS:11056)

The enumeration date for this NPI number is 4/16/2009 and was last updated on 7/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213ES0103XPodiatristFoot & Ankle Surgery695TENNESSEENo
2213ES0103XPodiatristFoot & Ankle Surgery2007024292MISSOURINo
3213ES0103XPodiatristFoot & Ankle Surgery242ARKANSASYes
4213ES0103XPodiatristFoot & Ankle Surgery80197MISSISSIPPINo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1180310717MEDICAIDARKANSAS
2199945716MEDICAIDARKANSAS
3180372748MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.