DR. JERRY ALLEN JR. BRADLEY (MD, EDD, MDIV) – Geriatric Medicine (Family Medicine) Physician, NPI 1376882563
Geriatric Medicine (Family Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,720 FAMILY PRACTICE in KY
Provider Addresses for DR. JERRY ALLEN JR. BRADLEY (MD, EDD, MDIV)
811 E PARRISH AVE
OWENSBORO, KY 423033258
Phone: (270) 688-2078
Type: Location
3601 SEMMES DR E
SEMMES, AL 365755389
Phone: (251) 404-3574
Type: Mailing
PO BOX 746450
ATLANTA, GA 303746450
Phone: (866) 401-3057
Fax: (318) 868-6430
Type: Mailing
575 STANTON RD
MOBILE, AL 366172344
Phone: (251) 471-7207
Fax: (251) 471-7207
Type: Location
4725 SYDNEY LN LOT A
OWENSBORO, KY 423019681
Phone: (251) 404-3574
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: 2025-07-23
PECOS data refreshed: 2026-06-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250723000053 | I | Family Practice | AL | TBD |
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.
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 42303)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Cardiovascular Disease (Cardiology) | FL | |
| Physician Assistant | AL | |
| Diagnostic Radiology | MS | |
| - | AL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | AL | |
| Cardiac Surgery, Vascular Surgery | GA | |
| Cardiovascular Disease (Cardiology), Internal Medicine | AL | |
| Interventional Radiology, Diagnostic Radiology | TN | |
| R H E U M A T O L O G Y | AL | |
| - | AL |
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