Douglas L Bradley (NPI# 1689669301, PAC ID# 1153459912) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
Nation Provider ID (NPI) | 1689669301 |
PAC ID by PECOS | 1153459912 |
Professional Enrollment ID | I20100514000714 |
Full Name | Douglas L Bradley |
Organization Legal Name | BELTON FAMILY PRACTICE CLINIC LLC |
Address |
17067 S Outer Rd Suite 100 Belton MO 64012-2100 |
Phone Number | 8163314000 |
Gender | M |
Graduation Year | 1980 |
Primary Specialty | FAMILY MEDICINE |
Group Practice PAC ID | 5193717601 |
Number of Group Practice Members | 9 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
260214 | BELTON REGIONAL MEDICAL CENTER |
261324 | CASS REGIONAL MEDICAL CENTER |
260085 | ST JOSEPH MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
17067 S Outer Rd, Suite 100, Belton, MO 64012-2100 | 8163314000 | BELTON FAMILY PRACTICE CLINIC LLC |
Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
---|---|---|---|
ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
Organization Legal Name | BELTON FAMILY PRACTICE CLINIC LLC |
Physicians | 9 |
Name | Specialty | Organization | Address |
---|---|---|---|
Zandra R Gottman | Nurse Practitioner | Belton Family Practice Clinic LLC | 17067 S Us Hwy 71, Suite 100, Belton, MO 64012-2100 |
David R Williams | Family Medicine | Belton Family Practice Clinic LLC | 17067 S Us Hwy 71, Suite 100, Belton, MO 64012-2100 |
Kent A Bogner | Family Medicine | Belton Family Practice Clinic LLC | 17067 S Us Hwy 71, Suite 100, Belton, MO 64012-2100 |
Logan F Kratt | Family Medicine | Belton Family Practice Clinic LLC | 17067 S Outer Rd, Suite 100, Belton, MO 64012-2100 |
Bridget M Stillwell | Nurse Practitioner | Belton Family Practice Clinic LLC | 17067 S Outer Rd, Suite 100, Belton, MO 64012-2100 |
Ossama Al-assafeen | Internal Medicine | Belton Family Practice Clinic LLC | 17067 S Outer Rd, Suite 100, Belton, MO 64012-2100 |
Kirk D Ridley | Family Medicine | Belton Family Practice Clinic LLC | 17067 S Us Hwy 71, Suite 100, Belton, MO 64012-2100 |
Purnima S Mohan | Family Practice | Belton Family Practice Clinic LLC | 17067 S Us Hwy 71, Suite 100, Belton, MO 64012-2100 |
Street Address |
17067 S OUTER RD SUITE 100 |
City | BELTON |
State | MO |
Zip | 64012-2100 |
Name | Specialty | Organization | Address |
---|---|---|---|
Shannon E Kohake | Neurology | Research Neurology Associates, LLC | 17067 S Outer Rd, Suite 200, Belton, MO 64012-2100 |
Brian P Mieczkowski | Internal Medicine | Kansas City Pulmonology Practice LLC | 17067 S Outer Rd, Suite 200, Belton, MO 64012-2100 |
Michael D Chacey | Pulmonary Disease | Kansas City Pulmonology Practice LLC | 17067 S Outer Rd, Suite 200, Belton, MO 64012-2100 |
Logan F Kratt | Family Medicine | Belton Family Practice Clinic LLC | 17067 S Outer Rd, Suite 100, Belton, MO 64012-2100 |
Lyndsey N Augur | Physician Assistant | Signature Medical Group of Kc Pa | 17067 S Outer Rd, Suite 301, Belton, MO 64012-2165 |
Timothy L Blackburn | Cardiovascular Disease (cardiology) | Midwest Heart and Vascular Specialists LLC | 17067 S Outer Rd, Suite 200, Belton, MO 64012-2100 |
Lindsey M Brown | Nurse Practitioner | Signature Medical Group of Kc Pa | 17067 S Outer Rd, Suite 301, Belton, MO 64012-2165 |
William Miles Beary | Pulmonary Disease | Kansas City Pulmonology Practice LLC | 17067 S Outer Rd, Suite 200, Belton, MO 64012-2100 |
Kathryn S Kincaide | Nurse Practitioner | Kansas City Pulmonology Practice LLC | 17067 S Outer Rd, Suite 200, Belton, MO 64012-2100 |
Bridget M Stillwell | Nurse Practitioner | Belton Family Practice Clinic LLC | 17067 S Outer Rd, Suite 100, Belton, MO 64012-2100 |
Find all physicians in the same address |
Name | Specialty | Organization | Address |
---|---|---|---|
Breann K Smith | Hospitalist | Connectcare Hospitalists LLC | 17065 S U S 71 Hwy, Belton Regional Medical Center, Belton, MO 64012 |
Melissa S Campbell | Nurse Practitioner | Connectcare Hospitalists LLC | 17065 S U S 71 Hwy, Belton Regional Medical Center, Belton, MO 64012 |
John Paul Armilio | Family Medicine | Connectcare Hospitalists LLC | 17065 S U S 71 Hwy, Belton Regional Medical Center, Belton, MO 64012 |
Nilofar D Rahman | Hospitalist | Connectcare Hospitalists LLC | 17065 S U S 71 Hwy, Belton Regional Medical Center, Belton, MO 64012 |
Amy W Gemperli | Ophthalmology | Heart of America Eye Care, P.a. | 424 E N Ave, Belton, MO 64012-2017 |
Amy E Ciccio | Ophthalmology | Heart of America Eye Care, P.a. | 424 E N Ave, Belton, MO 64012-2017 |
Ginger E Cline | Optometry | Heart of America Eye Care, P.a. | 424 E N Ave, Belton, MO 64012-2017 |
Alan E Bauman | Ophthalmology | State Line Eye Care Center, PC | 424 E N Ave, Cass County Eye Care Ctr, Belton, MO 64012-2017 |
Rick D Thomas | Clinical Psychologist | 409 N Scott Ave, Belton, MO 64012-2035 | |
Robert A Bondi | Podiatry | 115 Bradford Lane, Belton, MO 64012-2086 | |
Find all physicians in zip 64012 |
City | BELTON |
Zip Code | 64012 |
Specialty | FAMILY MEDICINE |
City + Specialty | BELTON + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Douglas L Bradley.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.