NIKKI B BRADLEY (M.D.) – Emergency Medicine Physician, NPI 1861434862

NIKKI B BRADLEY (M.D.) is a healthcare provider. based in Jonesboro, Georgia. specializing in Emergency Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 070718 (GA). The NPI Number for NIKKI B BRADLEY (M.D.) is 1861434862

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
NIKKI B BRADLEY (M.D.)
NPI
1861434862
Phone
(770) 603-3668
Address
2400 MT. ZION PARKWAY
Enumeration Date
12 June 2006
Last Update Date
7 September 2023

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Secondary Phone
7706033685
Graduation Year
2002 (24 years ago)
PAC ID
8921014069
Group Practice PAC ID
6204829013
Professional Enrollment ID
I20140422000465

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness85
Years active:19State licenses:2Other namesUpdated within 12 months

Provider Addresses for NIKKI B BRADLEY (M.D.)

  • 2400 MT. ZION PARKWAY

    KAISER PERMANENTE SOUTHWOOD COMPREHENSIVE MEDICAL CENTE

    JONESBORO, GA 30236

    Phone: (770) 603-3668

    Type: Location

  • Piedmont Road Northeast, Buckhead, Atlanta, Georgia, 30305, United States

    NINE PIEDMONT CENTER

    ATLANTA, GA 30305

    Phone: (404) 364-7070

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-04-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140422000465IEmergency MedicineGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30236)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6204829013View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to NIKKI B BRADLEY (M.D.)?
NPI 1861434862 is assigned to NIKKI B BRADLEY (M.D.) under the national enumeration system.
Is NIKKI B BRADLEY (M.D.) currently active in the NPI registry?
CMS-published data lists NIKKI B BRADLEY (M.D.) as an active registrant.
Can you summarize NIKKI B BRADLEY (M.D.)'s specialty in plain language?
Clinically, the directory lists NIKKI B BRADLEY (M.D.) with Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Does NIKKI B BRADLEY (M.D.) practice in Georgia?
You will see Jonesboro, Georgia on file for NIKKI B BRADLEY (M.D.) alongside any extra practice locations.
What if Jonesboro, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.