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BRADLEY PLACE
NPI 1376601302
Assisted Living Facility in Tifton, GA

Active since December 04, 2006CLIA 11D0951815 · Waiver
418 NORTH PARK AVE, TIFTON, GA 31794(229) 386-9789(229) 386-9307 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Bradley Place NPPES

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

BRADLEY PLACE (NPI 1376601302) is a healthcare organization registered as an assisted living facility in Tifton, Georgia and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through September 28, 2026 and lists William C Byrd, Owner President, as its authorized official.

NPPES Registry Identity

NPI1376601302
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameWILLIAM C BYRD INC
Location Address418 NORTH PARK AVETifton, GA 31794
Mailing AddressPo Box 890Tifton, GA 31793 · (229) 382-8655 · Fax (229) 382-7011
Phone(229) 386-9789
Fax(229) 386-9307
Organization SubpartNo
Authorized OfficialWilliam C ByrdOwner President · (229) 382-8655
Enumeration DateDecember 4, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1376601302 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
418 NORTH PARK AVE, Tifton, GA 31794
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Other Names 1

Doing Business AsBradley Place

Other Identifiers 1

Medicaid00747766CGA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D0951815

Bradley Place · Tifton, GA
Active · expires Sep 28, 2026
CLIA Number11D0951815
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 29, 2024
Certificate Expiration DateSeptember 28, 2026
Laboratory DirectorWilliam C. Byrd
Laboratory Phone(912) 386-9789
Laboratory LocationBradley Place418 North Park Ave, Tifton, GA 31794
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILLIAM C BYRD INC
Assisted Living Facility
418 NORTH PARK AVE
TIFTON, GA 31794
Tift County (229) 386-9789

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 William C Byrd Inc's NPI number?

The NPI number for William C Byrd Inc is 1376601302. It was assigned to this organization in the NPPES registry on December 4, 2006. The provider is doing business as Bradley Place.

Where is William C Byrd Inc located?

William C Byrd Inc is located at 418 North Park Ave, Tifton, GA 31794. The listed phone number is (229) 386-9789.

What is William C Byrd Inc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does William C Byrd Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0951815) is associated with this NPI, valid through September 28, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for William C Byrd Inc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.