Active NPI
Bradford Rayne Solomon, MS, RD, CSCS, ISAK
- Sports Dietetics Nutrition Registered Dietitian
- State College, PA
National Provider Identifier
1023926805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Dietetics Nutrition Registered Dietitian
- License
- 86151349
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.