Active NPI
Bradley Ian McMichael
- Physical Therapy Assistant
- Keizer, OR
National Provider Identifier
1043766116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 08866
- Practice address
- 4062 Arleta Ave NE
Keizer, OR 97303-4758 - Phone
- (503) 390-2271
- NPI assigned
- Aug 29, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 08866 | OR | Primary |
Addresses
Primary practice location
4062 Arleta Ave NE
Keizer, OR 97303-4758
Mailing address
1026 Hidden Creek Dr NE
Apt. 201
Keizer, OR 97303-7915
Phone (541) 603-1821
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08866 | OR | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472428800000",
"number": "1043766116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1026 HIDDEN CREEK DR NE",
"address_2": "APT. 201",
"city": "KEIZER",
"state": "OR",
"postal_code": "973037915",
"telephone_number": "541-603-1821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4062 ARLETA AVE NE",
"city": "KEIZER",
"state": "OR",
"postal_code": "973034758",
"telephone_number": "503-390-2271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMICHAEL",
"first_name": "BRADLEY",
"middle_name": "IAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-29",
"last_updated": "2016-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OR",
"license": "08866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keizer, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.