Bradley C. Brush, A.T.C., C.S.C.S.

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096-000308 Issued in IL

Practice address

305 W Jackson St
Suite LL02
Carbondale, IL 62901-1474

Phone

(618) 549-0721

Fax

(618) 529-0403

NPI assigned

Mar 9, 2006

Last updated

Dec 22, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229904000000",
    "number": "1013985613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S GREEN ST",
            "city": "ANNA",
            "state": "IL",
            "postal_code": "629061103",
            "telephone_number": "618-833-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W JACKSON ST",
            "address_2": "SUITE LL02",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-549-0721",
            "fax_number": "618-529-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSH",
        "first_name": "BRADLEY",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "A.T.C., C.S.C.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2008-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096-000308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley L. Brown, NP
• Gary Michael Brown, D.D.S.
• Regina Brown, PTA
• Brown's Family Medicine LLC
• Corey Michal Bruff, CRNA
• Michael Anthony Bryant, PA-C
• Jacqueline N Buck, PH.D.
• Tamara Buckles, MD
• F Dale Budslick, LCPC
• Seif Bugazia, MD

• Athletic Trainer in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.