Provider Demographics
NPI:1104847623
Name:MATTHEWS, BRADFORD JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:BRADFORD
Middle Name:JAMES
Last Name:MATTHEWS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5045 OLD HICKORY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2581
Mailing Address - Country:US
Mailing Address - Phone:615-515-9921
Mailing Address - Fax:615-620-1972
Practice Address - Street 1:5045 OLD HICKORY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2581
Practice Address - Country:US
Practice Address - Phone:615-515-9921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046270207RC0000X, 207RI0011X
TN72057207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1450771OtherCIGNA
VA60061531OtherRAILROAD MEDICARE
VA939829OtherMAMSI
TNT1258212OtherMEDICARE (TN)
VA47546OtherSENTARA HEALTH/OPTIMA
TNQ100167Medicaid
VA178957OtherANTHEM/VA HEALTHKEEPERS
VA276203OtherANTHEM/VA HEALTHKEEPERS
VA4469323OtherAETNA/US HEALTHCARE
VA128173OtherSOUTHERN HEALTH SERVICES
VA276252OtherANTHEM/VA HEALTHKEEPERS
VA103785OtherANTHEM/VA HEALTHKEEPERS
VA27413300OtherFEDERAL BLACK LUNG
VA276275OtherANTHEM/VA HEALTHKEEPERS
VA276358OtherANTHEM/VA HEALTHKEEPERS
VA276300OtherANTHEM/VA HEALTHKEEPERS
VA5851971Medicaid
VA595137OtherAETNA/US HEALTHCARE HMO
VA440261OtherANTHEM/VA HEALTHKEEPERS