BRADLEY E. HENDERSON (NPI# 1578550133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578550133 |
| Entity Type | Individual |
| Full Name | BRADLEY E. HENDERSON |
| Credential | M.D. |
| Practice Address |
1061 Harmon Ave Ste 1d03 Fort Stewart GA 31314-5641 |
| Mailing Address |
1061 Harmon Ave Ste1d03 Fort Stewart GA 31314-5641 |
| Practice Telephone | 9124356933 |
| Mailing Telephone | 9124356933 |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2009-01-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 030617 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000391025B | 05 | |
| GA | 000391025E | 05 |
| Street Address |
1061 HARMON AVE STE 1D03 |
| City | FORT STEWART |
| State | GA |
| Zip Code | 31314-5641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871596486 | Donald E Shackleford | Obstetrics & Gynecology | 1061 Harmon Ave, Fort Stewart, GA 31314 | 2005-05-27 |
| 1619575081 | Rudy Noel Torres Negron | Social Worker | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-10-16 |
| 1629675434 | Darryl B Moore | Counselor | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-10-05 |
| 1093330268 | Lesheia Tasker | Technician, Other | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-06-12 |
| 1770111270 | Kendal Padgett | Physical Therapist | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-30 |
| 1104452218 | Tiffany L Stark | Physician Assistant | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-20 |
| 1396371035 | Alicia Nichole Hasquin | Physician Assistant | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-13 |
| 1407481492 | Matthew Douglas Lueders | Student in an Organized Health Care Education/Training Program | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-10 |
| 1316572308 | Seth Ravid | Student in an Organized Health Care Education/Training Program | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-10 |
| 1487289526 | Huon Sharpe | Student in an Organized Health Care Education/Training Program | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932733995 | Heather Ziccarelli Deneen | Dietitian, Registered | 441 Bultman Ave, 1183, Fort Stewart, GA 31314 | 2020-02-28 |
| 1073099826 | Ross Emerick | Dentist | 351 West 6th Street, Fort Stewart, GA 31314 | 2018-07-16 |
| 1184154742 | Roland Garcia | Dentist | 351 W 6th St Bldg 440, Ft Stewart, GA 31314 | 2017-06-15 |
| 1548613045 | Sylvia Mclean | Dental Hygienist | 343 Vanguard Road, Fort Stewart, GA 31314 | 2016-07-20 |
| 1407209257 | David Wald Jr. | Dental Hygienist | 305 Vanguard Rd. Bldg 8335, Fort Stewar, GA 31314 | 2016-07-18 |
| 1376995415 | Alisha Potter | Dental Assistant | 305 Vangurard Road, Ft Stewart, GA 31314 | 2016-07-12 |
| 1538511068 | Brandi Harris | Dental Assistant | 305 Vanguard Rd, Ft Stewart, GA 31314 | 2016-07-08 |
| 1548612088 | Adrian Cuthbert | Dental Assistant | 305 Vanguard Road, Bldg 8435, Fort Stewart, GA 31314 | 2016-07-08 |
| 1841642386 | Beverly Lynn Berry | Dental Assistant | 306 Vanguard Road Bldg 8435, Fort Stewart, GA 31314 | 2016-07-08 |
| 1740630060 | Anjanette Nicole' Brown | Dental Assistant | 706 Warriors Rd, Building 2115, Fort Stewart, GA 31314 | 2016-06-17 |
| Find all providers in zip 31314 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| 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 Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093196180 | Matthew Scott Griffith | Orthopaedic Surgery | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2015-06-15 |
| 1932464757 | Aaron D Roberts | Orthopaedic Surgery | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2012-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386258 | Thrive Orthopaedics LLC | Orthopaedic Surgery | 5775 Peachtree Dunwoody Rd Ne Ste C150a, Atlanta, GA 30342-1501 | 2020-11-02 |
| 1568061000 | Esrpa | Orthopaedic Surgery | 1717 Benhill Dr, Snellville, GA 30078-2595 | 2020-10-24 |
| 1588273122 | Mallory Mary Garretson | Orthopaedic Surgery | 3240 N E Expy Ne Ste 100, Atlanta, GA 30341-4003 | 2020-07-29 |
| 1982248597 | Atlanta Area Orthopedics and Regenerative Medicine LLC | Orthopaedic Surgery | 2878 Five Forks Trickum Rd Ste 2c, Lawrenceville, GA 30044-5896 | 2019-11-06 |
| 1821639758 | Optim Orthopedics, LLC | Orthopaedic Surgery | 586 Islands Hwy, Midway, GA 31320-5962 | 2019-10-02 |
| 1396306197 | Athens Orthopedic Clinic, Pa | Orthopaedic Surgery | 1000 Cowles Clinic Way Ste A-400, Greensboro, GA 30642-5289 | 2019-06-24 |
| 1588121123 | 2019 Coastal Orthopedics Surgical Assist LLC | Orthopaedic Surgery | 8882 Abercorn St, Savannah, GA 31406-4508 | 2019-03-01 |
| 1386108769 | Focus Orthopaedics and Sports Medicine PC | Orthopaedic Surgery | 642 Hospital Rd, Commerce, GA 30529-1142 | 2019-01-30 |
| 1326523572 | Athens Orthopedic Clinic, Pa | Orthopaedic Surgery | 2108 Teron Trce Ste 100, Dacula, GA 30019-1666 | 2018-10-03 |
| 1831670322 | Performance Orthopaedics & Sports Medicine | Orthopaedic Surgery | 755 Mount Vernon Hwy Ne Ste 305, Atlanta, GA 30328-4274 | 2018-08-23 |
| Find all providers with the same taxonomy | ||||
| City | FORT STEWART |
| Zip Code | 31314 |
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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.