Dr. Bradley Stevens Jackson, M.D.
Emergency Medicine in Kansas City, KS. Individual provider (NPI-1).
NPI number1487940243
StatusActive
Last updated in NPPESJun 21, 2011
Details
- NPI
- 1487940243
- Entity type
- Individual (NPI-1)
- Name
- Dr. Bradley Stevens Jackson
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 21, 2011
- Last updated
- Jun 21, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - EMERGENCY MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | 9407745 | KS | Yes |
Practice location
3901 Rainbow BlvdKansas City, KS 66103-2937
Phone 913-588-1559
Mailing address
3901 Rainbow BlvdKansas City, KS 66103-2937
Phone 913-588-1559
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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