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BRADLEY FAREL HATHAWAY
NPI 1003643412
Student in an Organized Health Care Education/Training Program in Greenville, MS

Active since September 18, 2024PECOS Enrolled
167 BAYOU RD, GREENVILLE, MS 38701(662) 820-3939 Get Directions Write a Review

NPPES record last updated: September 18, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bradley Farel Hathaway NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRADLEY FAREL HATHAWAY (NPI 1003643412) is an individual student in an organized health care education/training program in Greenville, Mississippi and active in the NPI registry since September 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003643412
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameBRADLEY FAREL HATHAWAY
Location Address167 BAYOU RDGreenville, MS 38701-7732
Mailing Address167 Bayou RdGreenville, MS 38701-7732 · (662) 820-3939
Phone(662) 820-3939
Sole ProprietorNo
Enumeration DateSeptember 18, 2024
NPPES CertifiedSeptember 18, 2024
✔ NPI 1003643412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
167 BAYOU RD, Greenville, MS 38701
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bradley Farel Hathaway is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bradley Hathaway's NPI number?

The NPI number for Bradley Hathaway is 1003643412. It was assigned to this individual provider in the NPPES registry on September 18, 2024.

Where is Bradley Hathaway located?

Bradley Hathaway practices at 167 Bayou Rd, Greenville, MS 38701. The listed phone number is (662) 820-3939.

What is Bradley Hathaway's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Bradley Hathaway enrolled in Medicare?

Yes. Bradley Hathaway is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bradley Hathaway was last updated on September 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.