Dr Jeremy Gilliam Bradley, MD is a medicare enrolled "Pediatrics" physician in Waverly, Tennessee. His current practice location is
300 S Clydeton Rd, Waverly, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(931) 296-2737.
Dr Jeremy Gilliam Bradley is licensed to practice in Tennessee (license number 74029) 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 1922362722.
Physician's Profile
| Full Name | Dr Jeremy Gilliam Bradley |
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| Gender | Male |
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| Speciality | Pediatrics |
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| Location | 300 S Clydeton Rd, Waverly, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1922362722
- Provider Enumeration Date: 06/27/2012
- Last Update Date: 11/20/2025
Medicare PECOS Information:
- PECOS PAC ID: 8426364423
- Enrollment ID: I20150908000762
Medical Identifiers
Medical identifiers for Dr Jeremy Gilliam Bradley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1922362722 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208000000X | Pediatrics | 74029 (Tennessee) | 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 Jeremy Gilliam Bradley allows following entities to bill medicare on his behalf.
| Entity Name | Childrens Hospital Of The Kings Daughters Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1578954590
PECOS PAC ID: 0941265284
Enrollment ID: O20150623001707 |
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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 Jeremy Gilliam Bradley 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 Address | Practice Location Address |
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Dr Jeremy Gilliam Bradley, MD
127 Crestview Park Dr Ste 209,
Dickson, TN 37055-2856
Ph: (615) 446-5121 | Dr Jeremy Gilliam Bradley, MD
300 S Clydeton Rd,
Waverly, TN 37185-2140
Ph: (931) 296-2737 |
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