BRADLEY EDWARD TALLEY (NPI# 1548471618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548471618 |
| Entity Type | Individual |
| Full Name | BRADLEY EDWARD TALLEY |
| Credential | M.D. |
| Practice Address |
1705 Christy Dr Ste. 101 Jefferson City MO 65101-5195 |
| Practice Telephone | 5736350115 |
| Practice Fax Number | 5736350116 |
| Mailing Telephone | 5736350115 |
| Mailing Fax Number | 5736350116 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2015-06-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 2013006634 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MEDICARE NPI | 1548471618 | 01 |
| MO | 1548471618 | 05 |
| Street Address |
1705 CHRISTY DR STE. 101 |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65101-5195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528060704 | Cmmp Surgical Center LLC | Clinic/Center | 1705 Christy Dr, Ste 100, Jefferson City, MO 65101-5195 | 2005-06-01 |
| 1124491345 | Sierra Binkley | Physical Therapist | 1705 Christy Dr, Ste 200, Jefferson City, MO 65101-5195 | 2015-11-10 |
| 1255762852 | Capital Region Medical Center | Family Medicine | 1705 Christy Dr, Suite 201, Jefferson City, MO 65101-5195 | 2013-12-06 |
| 1063757003 | Jessica Lynn Clark | Physical Therapist | 1705 Christy Dr, Suite 200, Jefferson City, MO 65101-5195 | 2012-12-03 |
| 1073868808 | Central Missouri Diagnostic Services, LLC | Clinical Medical Laboratory | 1705 Christy Dr, Suite 105, Jefferson City, MO 65101-5195 | 2012-07-18 |
| 1780958173 | Capital Region Medical Center | Specialist | 1705 Christy Dr, Suite 215, Jefferson City, MO 65101-5195 | 2012-03-02 |
| 1750691143 | David Cranston | Physical Therapist | 1705 Christy Dr, Ste. 200, Jefferson City, MO 65101-5195 | 2010-10-19 |
| 1023346715 | Elizabeth A Farmer | Physical Therapist | 1705 Christy Dr, Suite 200, Jefferson City, MO 65101-5195 | 2009-11-18 |
| 1508094251 | Donnetta Lynn Wilkerson | Physical Therapist | 1705 Christy Dr, Suite 200, Jefferson City, MO 65101-5195 | 2009-07-01 |
| 1457594814 | Tamara V. Hopkins, M.d., L.L.C. | Internal Medicine | 1705 Christy Dr, Suite 201, Jefferson City, MO 65101-5195 | 2009-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619468527 | Lhcg Cxxxxiii, LLC | Home Health | 1125 Madison St Ste C, Jefferson City, MO 65101 | 2018-05-25 |
| 1396254629 | Lauren Mellon | Speech-Language Pathologist | 6124 Falcon Lane, Jefferson City, MO 65101 | 2017-09-29 |
| 1518375708 | Daven Nanda | Pharmacist | 2101 N Schotthill Woods Dr., Jefferson City, MO 65101 | 2014-07-31 |
| 1699183228 | Mark Nitz | Pharmacist | 2101 N Schotthill Dr, Jefferson City, MO 65101 | 2014-07-28 |
| 1386923472 | Lorinda Jo Leer | Occupational Therapist | 1403 Riverside Drive, Jefferson City, MO 65101 | 2011-08-08 |
| 1124334503 | Kimberly K Baumhoer | Hearing Instrument Specialist | 315 Ellis Blvd. Suite 202, Hearing Aid Consultants, Jefferson City, MO 65101 | 2010-08-24 |
| 1780867341 | Health Enhancements, P.C. | Family Medicine | 1739 Elm Court Plaza, Suite 106, Jefferson City, MO 65101 | 2007-12-06 |
| 1336364819 | Jerome Satorre | Occupational Therapist | 505 Ellis Blvd, Apt B20, Jefferson, MO 65101 | 2007-04-17 |
| 1326263450 | Bryan M. Pope, Dds Inc. | Dentist | 200 St. Mary's Medical Plaza, Suite 101, Jefferson City, MO 65101 | 2007-04-16 |
| 1104948769 | Kenneth Mark Skouby | Social Worker | 515a East Mccarty, Jefferson City, MO 65101 | 2007-04-04 |
| Find all providers in zip 65101 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962842476 | Philip Joseph Wilson IIi | Ophthalmology | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2013-06-28 |
| 1619033644 | Jefferson City Medical Group, P.C. | Ophthalmology | 1241 W Stadium Blvd, Suite 1020, Jefferson City, MO 65109-6023 | 2006-12-27 |
| 1821057449 | Andrew L. Weiss | Ophthalmology | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2006-03-22 |
| 1053385096 | Capital Region Medical Center | Ophthalmology | 1432 Southwest Blvd, Jefferson City, MO 65109 | 2006-02-15 |
| 1568436509 | Larry K Stauffer | Ophthalmology | 1432 Southwest Blvd, Jefferson City, MO 65109 | 2006-02-15 |
| 1225013121 | Robert P. Wankum | Ophthalmology | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2005-12-13 |
| 1114902327 | Philip J. Wilson II | Ophthalmology | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2005-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780299578 | Heart of America Eye Care Pa | Ophthalmology | 1147 E North Ave, Belton, MO 64012-5105 | 2020-09-09 |
| 1962020644 | Matthew Theodore Hirabayashi | Ophthalmology | University Hospital One Hospital Dr Dc052.00, Columbia, MO 65212-0001 | 2020-07-09 |
| 1508484288 | Travis Parker | Ophthalmology | University Hospital One Hospital Drive Dc 052.00, Columbia, MO 65212-0001 | 2020-07-09 |
| 1003466897 | Mcelhinney Eye Care, Pa | Ophthalmology | 1004 Carondelet Dr Ste 405, Kansas City, MO 64114-4801 | 2019-09-13 |
| 1952965493 | Eric Jiaming Zhang | Ophthalmology | University Hospital One Hospital Dr Dc.052.00, Columbia, MO 65212-0001 | 2019-04-30 |
| 1790265759 | Washington University | Ophthalmology | 4901 Forest Park Ave # 8221, Saint Louis, MO 63108-1495 | 2018-08-20 |
| 1023597127 | Eye Care Pa | Ophthalmology | 1018 W Foxwood Drive, Raymore, MO 64083 | 2018-08-09 |
| 1255716221 | Summit Eye Center, LLC | Ophthalmology | 1621 Nw Blue Parkway, Lees Summit, MO 64086 | 2015-07-20 |
| 1184038986 | Grace L Paley | Ophthalmology | 621 S New Ballas Rd Ste 5006b, Saint Louis, MO 63141-8270 | 2014-06-19 |
| 1871907378 | Daniel Joseph Watson | Ophthalmology | 900 N Highway 67 St, Florissant, MO 63031 | 2014-06-12 |
| Find all providers with the same taxonomy | ||||
| City | JEFFERSON CITY |
| Zip Code | 65101 |
Please comment or provide details below to improve the information on BRADLEY EDWARD TALLEY.
| 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.