DR. MELISSA BRADLEY
NPI 1619350915
Dentist - General Practice in Jackson, MS

Q: What is Melissa Bradley's NPI number?

The NPI number for Melissa Bradley is 1619350915. It was assigned to this individual provider in the NPPES registry on July 6, 2015.

Q: What is Melissa Bradley's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Melissa Bradley was last updated on December 31, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since July 06, 2015PECOS Enrolled

3502 W NORTHSIDE DR, JACKSON, MS 39213(601) 362-5321(601) 364-5153 Get Directions Write a Review

NPPES record last updated: December 31, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Dr. Melissa Bradley NPPES

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

DR. MELISSA BRADLEY (NPI 1619350915) is an individual general practice provider in Jackson, Mississippi, licensed in Illinois (019030213) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619350915

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDR. MELISSA BRADLEY

Location Address3502 W NORTHSIDE DRJackson, MS 39213-4454

Mailing Address3502 W Northside DrJackson, MS 39213-4454 · (601) 362-5321 · Fax (601) 364-5153

Phone(601) 362-5321

Fax(601) 364-5153

Sole ProprietorNo

Enumeration DateJuly 6, 2015

Last NPPES UpdateDecember 31, 2018

✔ NPI 1619350915 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in IL · 019030213

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

3502 W NORTHSIDE DR, Jackson, MS 39213

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Melissa Bradley 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.

Medicare Billing Reassignment

Medicare enrollment records show Melissa Bradley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Central Mississippi Civic Improvement Association, Inc

Same address

Federally Qualified Health Center (FQHC)

3502 W NORTHSIDE DR
Jackson, MS 39213

Reassigned Medicare billing, Mississippi enrollment
69 clinicians in this Medicare group

NPI 1134151442 (601) 362-5321

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39213 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$64.96 typical visit price

range $16.15 – $129.61

Typical copayment $16.24 (range $4.03 – $32.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

MRS. TIFFANI RICCHELE MCKNIGHT

Social Worker (Clinical)