Individual provider Active NPI

Bradford Rayne Solomon, MS, RD, CSCS, ISAK

  • Sports Dietetics Nutrition Registered Dietitian
  • State College, PA
National Provider Identifier
1023926805
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Dietetics Nutrition Registered DietitianTaxonomy code 133VN1501X
License
86151349 Issued in PA
Practice address
637 Crandall Dr
State College, PA 16803-1212
Phone
(792) 499-1036
NPI assigned
Aug 31, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Dietetics Nutrition Registered Dietitian 133VN1501X 86151349 PA Primary

Addresses

Primary practice location

637 Crandall Dr
State College, PA 16803-1212

Mailing address

637 Crandall Dr
State College, PA 16803-1212
Phone (792) 499-1036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1023926805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 CRANDALL DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168031212",
            "telephone_number": "792-499-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 CRANDALL DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168031212",
            "telephone_number": "792-499-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "BRADFORD",
        "middle_name": "RAYNE",
        "credential": "MS, RD, CSCS, ISAK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "PA",
            "license": "86151349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.