DR. CHARLES SHANNON BRADFORD JR. (NPI# 1811215643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811215643 |
| Entity Type | Individual |
| Full Name | DR. CHARLES SHANNON BRADFORD JR. |
| Credential | M.D. |
| Practice Address |
1133 Eagles Landing Pkwy Stockbridge GA 30281-5085 |
| Mailing Address |
35 Collier Rd Nw Ste 635 Atlanta GA 30309-1611 |
| Practice Telephone | 6786041000 |
| Mailing Telephone | 4043673014 |
| Mailing Fax Number | 9043485627 |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2018-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | ME123871 | FL | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 070347 | GA | Allopathic & Osteopathic Physicians |
| Y | 208M00000X | Hospitalist | 070347 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003136131A | 05 | |
| GA | RAILROAD MEDICARE | P01207903 | 01 |
| FL | 014816300 | 05 | |
| SC | GA1558 | 05 | |
| FL | RAILROAD MEDICARE | P01476268 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194281584 | Charles Bradford | Nurse Practitioner | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2019-02-11 |
| 1518321868 | Charles Bradford | Counselor | 609 Northshore Dr, Bellingham, WA 98226-4414 | 2016-04-12 |
| 1700805082 | Charles Raymond Bradford IIi | Family Medicine | 508 Harley St, Suite D, Scottsboro, AL 35768-4294 | 2006-07-18 |
| 1427085133 | Charles Raymond Bradford Iv | Family Medicine | 508 Harley St, Suite B, Scottsboro, AL 35768-4294 | 2006-06-27 |
| Street Address |
1133 EAGLES LANDING PKWY |
| City | STOCKBRIDGE |
| State | GA |
| Zip Code | 30281-5085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407842545 | Rhonda Carolyn Bloschock | Nurse Anesthetist, Certified Registered | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2005-09-23 |
| 1588279772 | Diagnostic Pathology Associates PC | Pathology | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2020-09-14 |
| 1619594843 | Rowena Zheng | Physical Therapist | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2020-07-03 |
| 1497380539 | Tomoyo Kuriyama | Nurse Practitioner | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2020-03-09 |
| 1740827971 | Echiline Francois | Nurse Practitioner | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2019-12-06 |
| 1639726441 | Jessica Ramey | Anesthesiologist Assistant | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2019-08-26 |
| 1295382802 | Briana Nicole Tate-york | Anesthesiologist Assistant | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2019-08-20 |
| 1619520293 | Wendy March Greenway | Nurse Practitioner | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2019-07-22 |
| 1528526548 | Kisha Meshun Smith | Registered Nurse | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2019-03-08 |
| 1356807895 | Shellie Nicole Welch | Registered Nurse | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2019-02-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039095 | Colette Alls | Social Worker | 447 Lakeshore Dr, Stockbridge, GA 30281 | 2020-09-24 |
| 1982216800 | Pediatric and Family Behavioral Health of Georgia | Counselor | 1004 Ulster Court, Stockbridge, GA 30281 | 2020-08-21 |
| 1518577659 | Qunique Taveka Toxey | Behavior Technician | 115 N Park Trail, Suite 123, Stockbridge, GA 30281 | 2020-08-04 |
| 1497377675 | Melanie Harvey | Pharmacist | 4467 North Henry Boulevard, Stockbridge, GA 30281 | 2020-05-11 |
| 1114550571 | Cecile Maria Dunkley Layne | Counselor | 255 Corporte Drive, Stockbridge, GA 30281 | 2020-02-13 |
| 1306407143 | Palliative Care of Georgia. LLC | Home Health | 275 Corporate Center Court Ste C, Stockbridge, GA 30281 | 2019-06-24 |
| 1154883791 | Aaliyah Nura Fardan-alexander | Nurse's Aide | 105 Singletree, Stockbridge, GA 30281 | 2019-04-02 |
| 1306306261 | Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 150 County Club Drive, Suite 200, Stockbridge, GA 30281 | 2019-03-25 |
| 1356814172 | Kristina Louissaint | Nurse Practitioner | 650 Country Club Dr, Stockbridge, GA 30281 | 2019-01-03 |
| 1942789284 | Cameren Barnes | Physical Therapist | 5473 N Henry Blvd, Stockbridge, GA 30281 | 2018-08-08 |
| Find all providers in zip 30281 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548219660 | Piedmont Hospitalist Physicians LLC | Hospitalist | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033770771 | Your Hospitalist Team LLC | Hospitalist | 2215 Autumn Ridge Ln, Cumming, GA 30041-1358 | 2019-06-24 |
| 1780194183 | Mobin Shah Inc | Hospitalist | 352 Langshire Dr, Mcdonough, GA 30253-8055 | 2017-10-11 |
| 1972036721 | Getnet Alemu Tioum | Hospitalist | 1267 Pounds Ln, Clarkston, GA 30021-2830 | 2017-04-08 |
| 1720531692 | Zahraa Rabeeah | Hospitalist | 390 17th St Nw Unit 5031, Atlanta, GA 30363-2015 | 2016-07-27 |
| 1245614973 | Donovan Philbrick | Hospitalist | 743 Spring Street, Office of Inpatient Medicine, Gainesville, GA 30501 | 2015-07-13 |
| 1932529732 | Munir Chaudhuri | Hospitalist | 1364 Clifton Road Ne Box M7, Atlanta, GA 30322-1029 | 2014-04-18 |
| 1982979373 | Rianot Amzat | Hospitalist | 5665 Peachtree Dunwoody # Ga, Suite 500, Atlanta, GA 30342-1701 | 2012-03-19 |
| 1780970921 | Christopher Thomas Middendorf | Hospitalist | 1400 River Place, Braselton, GA 30517 | 2011-06-27 |
| 1043528268 | Medcare Physicians of Central Georgia, LLC | Hospitalist | 1040 Founders Row, Ste A, Greensboro, GA 30642-5261 | 2010-09-22 |
| 1619293354 | Aaron D Gluth | Hospitalist | 1364 Clifton Rd Ne Box M-7, Atlanta, GA 30322-1059 | 2010-04-19 |
| Find all providers with the same taxonomy | ||||
| City | STOCKBRIDGE |
| Zip Code | 30281 |
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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.