MR. BRADLEY JEFF STEPHENSON (NPI# 1134266901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134266901 |
| Entity Type | Individual |
| Full Name | MR. BRADLEY JEFF STEPHENSON |
| Credential | P.T. |
| Practice Address |
102 Ridgemont Villa Booneville MS 38829-1036 |
| Mailing Address |
503 Constitution Dr Iuka MS 38852-8605 |
| Practice Telephone | 6627207050 |
| Practice Fax Number | 6627207055 |
| Mailing Telephone | 6624249500 |
| Mailing Fax Number | 6624249592 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2016-01-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | PT3039 | MS | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 03256731 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104180975 | Bradley Daniel Stephenson | Physician Assistant | 8402 Harcourt Rd Ste 125, Indianapolis, IN 46260-2094 | 2012-06-27 |
| Street Address |
102 RIDGEMONT VILLA |
| City | BOONEVILLE |
| State | MS |
| Zip Code | 38829-1036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992941165 | Chr of Booneville, Inc. | Clinic/Center | 102 Ridgemont Villa, Booneville, MS 38829-1036 | 2008-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962029249 | Ortho Express Holding Company, LLC | Clinic/Center | 608 W Church St, Booneville, MS 38829 | 2020-07-02 |
| 1073142600 | Chelsea Cara Mcmillin | Registered Nurse | 2014 C East Chambers Drive, Booneville, MS 38829 | 2020-04-06 |
| 1396210274 | Hooper Transportation LLC | Private Vehicle | 105 Jacinto Heights, No 2, Booneville, MS 38829 | 2018-10-08 |
| 1699251314 | John L Hooper | Driver | 105 Jacinto Heights No 2, Booneville, MS 38829 | 2018-07-16 |
| 1750744389 | Jeni Ramey | Social Worker | 214 Dogwood Estates, Booneville, MS 38829 | 2016-03-31 |
| 1770944977 | Judy Dillard | Peer Specialist | 2100 Chambers Drive, Booneville, MS 38829 | 2016-03-15 |
| 1508253295 | Mary Grace Hancock | Internal Medicine | 202 N 1st St Ste B, Booneville, MS 38829 | 2015-04-20 |
| 1508042722 | Mary Dean Stone | Registered Nurse | 2100 East Chamberss, Booneville, MS 38829 | 2008-01-17 |
| 1144406430 | Amy Cole | Registered Nurse | 2100 East Chambers, Booneville, MS 38829 | 2008-01-16 |
| 1972715118 | Rita D. Jones | Nurse Practitioner | 1907 South Lake Street, Booneville, MS 38829 | 2007-05-03 |
| Find all providers in zip 38829 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407407273 | Holly Wilson | Specialist | 100 Hospital St Ste 300, Booneville, MS 38829-3354 | 2019-09-24 |
| 1598762890 | Joseph Woodson Wolfe | Specialist | 100 Hospital St, Suite 100a, Booneville, MS 38829-3354 | 2005-06-30 |
| 1548489636 | Urology Consultants, Pllc | Specialist | 100 Hospital St, Suite 100a, Booneville, MS 38829-3354 | 2007-04-25 |
| 1588623532 | David G Chase Sr. | Specialist | 100 Hospital St, Suite 300, Booneville, MS 38829-3354 | 2006-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255893434 | Natasha Wilson | Specialist | 959 Memorial Blvd, Picayune, MS 39466-4635 | 2019-04-05 |
| 1669933396 | Doneshia Brown | Specialist | 1436 Saint Andrews Ln, Starkville, MS 39759-1613 | 2019-03-26 |
| 1770061442 | Elizabeth Newcomb | Specialist | 102 N Cass St Ste B, Corinth, MS 38834-5729 | 2018-08-03 |
| 1396271565 | Karlisha Britton | Specialist | 7 Lakeland Circle, Suite 300, Jackson, MS 39216 | 2017-05-10 |
| 1306386784 | Donna Neal | Specialist | 2113 Government St Ste K2, Ocean Springs, MS 39564-3949 | 2017-03-03 |
| 1790227627 | Mississippi Center for Advanced Medicine, PC | Specialist | 7731 Old Canton Rd, Suite B, Madison, MS 39110-6114 | 2016-11-09 |
| 1366993321 | D Balder Md Pllc | Specialist | 15190 Community Rd Ste 210, Gulfport, MS 39503-3483 | 2016-10-14 |
| 1619427374 | Anthony Jamaal Anderson | Specialist | 295 Debuys Rd, Gulfport, MS 39507-2800 | 2016-10-06 |
| 1114476389 | Physician Practice of Madison, PC | Specialist | 1111 N Frontage Rd Fl 2, Vicksburg, MS 39180-5102 | 2016-09-28 |
| 1376098236 | Allison Bounds | Specialist | 831 Rice Rd, Ridgeland, MS 39157-3022 | 2016-08-22 |
| Find all providers with the same taxonomy | ||||
| City | BOONEVILLE |
| Zip Code | 38829 |
Please comment or provide details below to improve the information on MR. BRADLEY JEFF STEPHENSON.
| 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.