DR. JESSE H. BRADLEY JR. (NPI# 1114160389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114160389 |
Entity Type | Individual |
Full Name | DR. JESSE H. BRADLEY JR. |
Credential | D.P.M. |
Practice Address |
116 W Tyler Ave Suite B West Memphis AR 72301-4221 |
Mailing Address |
Po Box 1752 West Memphis AR 72303-1752 |
Practice Telephone | 8707330888 |
Practice Fax Number | 8707330889 |
Mailing Telephone | 8707330888 |
Mailing Fax Number | 8707330889 |
Enumeration Date | 2009-04-16 |
Last Update Date | 2020-07-22 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
80197 | MS | Podiatric Medicine & Surgery Service Providers |
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
242 | AR | Podiatric Medicine & Surgery Service Providers |
N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
2007024292 | MO | Podiatric Medicine & Surgery Service Providers |
N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
695 | TN | Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | 180310717 | 05 | |
AR | 199945716 | 05 | |
AR | 180372748 | 05 |
Street Address |
116 W TYLER AVE SUITE B |
City | WEST MEMPHIS |
State | AR |
Zip Code | 72301-4221 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235755497 | Shannon Mcelroy | Pharmacist | 300 I-40 Service Rd, West Memphis, AR 72301 | 2020-06-23 |
1891319745 | Heather Nichole Fesperman | Nurse Practitioner | 420 W Cooper Ave, West Memphis, AR 72301 | 2020-06-05 |
1174161475 | Mary Williams | Pharmacist | 300 I-40 Service Road, West Memphis, AR 72301 | 2019-12-17 |
1336787035 | Yolanda Monique Fulton | Assisted Living Facility | 711 Purduve Ave, West Memphis, AR 72301 | 2019-12-13 |
1255813317 | Urgent Care Travel, Inc | Clinic/Center | 3400 Service Loop 2, West Memphis, AR 72301 | 2018-09-05 |
1841770302 | Cuffie Healthcare LLC | Home Health | 403 Ingram Blvd, West Memphis, AR 72301 | 2018-08-15 |
1467940312 | Mark Aaron Whitlock | Dentist | 110 Dover Rd, West Memphis, AR 72301 | 2018-04-26 |
1043715329 | Crossroads Treatment Center of West Memphis, PC | Clinic/Center | 103 S Avalon St, West Memphis, AR 72301 | 2018-03-28 |
1114445202 | Deborah Thompson Ferguson | Dentist | 200 S Rhodes St Ste B, West Memphis, AR 72301 | 2017-09-08 |
1154745487 | Erin Camille Greer | Specialist/Technologist | 610 N. Missouri Street, Suite 1, West Memphis, AR 72301 | 2014-02-06 |
Find all providers in zip 72301 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477881092 | Bradley Footcare LLC | Podiatrist | 116 W Tyler Ave Ste B, West Memphis, AR 72301-4221 | 2009-11-19 |
1154571495 | Mid-south Foot & Ankle Clinic P C | Podiatrist | 302 S Rhodes St, West Memphis, AR 72301-4215 | 2008-09-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649791369 | Kyle Haverstrom | Podiatrist | 200 S 20th St Ste B, Rogers, AR 72758-1100 | 2017-07-03 |
1609288984 | Aaron Teufel | Podiatrist | 1794 E Joyce Blvd Ste 2, Fayetteville, AR 72703 | 2014-05-21 |
1568716744 | Spencer Lewis Mortensen | Podiatrist | 1500 Dodson Ave Ste 260, Fort Smith, AR 72901-5179 | 2012-11-09 |
1982968574 | Adam Lloyd Bingham | Podiatrist | 1713 W Main St, Russellville, AR 72801-2721 | 2012-06-27 |
1235314147 | Stephanie A. Roth | Podiatrist | 703 W Main St, Russellville, AR 72801-3616 | 2008-01-09 |
1144341827 | Carlotta Monique Wells | Podiatrist | 1132 Malvern Ave, Hot Springs, AR 71901-6347 | 2007-04-02 |
1407936388 | Angela Lorraine Ayson | Podiatrist | 11 Halsted Cir Ste E, Rogers, AR 72756-3145 | 2006-10-16 |
1295743557 | Crotty Foot Clinic P A | Podiatrist | 6600 Rogers Ave, Fort Smith, AR 72903-4064 | 2006-08-03 |
1104842814 | Joseph M. Lacava | Podiatrist | 3339 Central Ave, Suite F, Hot Springs, AR 71913-6138 | 2006-07-14 |
1942243787 | Reel Family Foot Clinic, P.a. | Podiatrist | 201 E Parkway Dr, Russellville, AR 72801-3913 | 2006-06-13 |
Find all providers with the same taxonomy |
City | WEST MEMPHIS |
Zip Code | 72301 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.