Dr Bradly Shane Holland, DO - Medicare Emergency Medicine in Gravette, AR

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Dr Bradly Shane Holland, DO is a medicare enrolled "Emergency Medicine" physician in Gravette, Arkansas. His current practice location is 1101 Jackson St Sw, Gravette, Arkansas. You can reach out to his office (for appointments etc.) via phone at (479) 787-5291.

Dr Bradly Shane Holland is licensed to practice in Arkansas (license number E5111) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1619905692.

Contact Information

Dr Bradly Shane Holland, DO
1101 Jackson St Sw,
Gravette, AR 72736-9121
(479) 787-5291
(479) 344-6404

Map and Direction




Physician's Profile

Full NameDr Bradly Shane Holland
GenderMale
SpecialityEmergency Medicine
Location1101 Jackson St Sw, Gravette, Arkansas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1619905692
  • Provider Enumeration Date: 06/29/2006
  • Last Update Date: 08/10/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 9830151265
  • Enrollment ID: I20070921000576

Medical Identifiers

Medical identifiers for Dr Bradly Shane Holland such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1619905692NPI-NPPES
4119511OtherTNBCBS OF TN
3300823MedicaidTN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 1639 (Tennessee)Secondary
207P00000XEmergency Medicine E5111 (Arkansas)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Bradly Shane Holland allows following entities to bill medicare on his behalf.
Entity NameSoutheastern Emergency Physicians Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356379382
PECOS PAC ID: 2466364997
Enrollment ID: O20050418001201
Entity NameSgoh Acquisition Inc
Entity TypePart B Supplier - Hospital Department(s)
Entity IdentifiersNPI Number: 1568643005
PECOS PAC ID: 5092616276
Enrollment ID: O20081016000559
Entity NameSouth Arkansas Emergency Physicians Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942435458
PECOS PAC ID: 4486705720
Enrollment ID: O20090629000005
Entity NameEmergency Staffing Solutions Region Iii
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1689967895
PECOS PAC ID: 3375721707
Enrollment ID: O20110706000473
Entity NameHcc Of Magnolia Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1831865872
PECOS PAC ID: 3779980750
Enrollment ID: O20210917000064

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Bradly Shane Holland is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Bradly Shane Holland, DO
1217 Glencliff Dr,
Kingsport, TN 37663-2892

Ph: () -		Dr Bradly Shane Holland, DO
1101 Jackson St Sw,
Gravette, AR 72736-9121

Ph: (479) 787-5291

Reviews and Comments


Emergency Medicine Doctors in Gravette, AR

Kenneth C. Stewart, D.O.
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 1101 Jackson St Sw, Gravette, AR 72736
Phone: 479-787-5291    
Glen F Mcspadden, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1101 Jackson St Sw, Gravette, AR 72736
Phone: 479-787-5291    Fax: 479-344-6404
Donald Tribbey, D.O.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 1101 Jackson St Sw, Gravette, AR 72736
Phone: 479-787-5291    Fax: 479-344-6404
Steven L. Williams, D.O.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 1101 Jackson St Sw, Gravette, AR 72736
Phone: 479-787-5291    Fax: 479-344-6410

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.