Active NPI
Lakyn Bradley, PT DPT
- Physical Therapist
- Jonesborough, TN
National Provider Identifier
1043955990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17568
- Practice address
- 806 E Jackson Blvd Ste 15
Jonesborough, TN 37659-1536 - Phone
- (423) 753-2805
- NPI assigned
- May 4, 2022
- Last updated
- Sep 4, 2026
- Sex
- Female
- 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 Therapist | 225100000X | 17568 | TN | Primary |
Addresses
Primary practice location
806 E Jackson Blvd Ste 15
Jonesborough, TN 37659-1536
Mailing address
1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-8995
Other practice location 1
4120 Waverly Rd
Huntington, WV 25704-1127
Phone (606) 324-0540
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | billing@tristaterehab.com | Direct |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788480000000",
"number": "1043955990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 CORPORATE DR STE 400",
"city": "HOOVER",
"state": "AL",
"postal_code": "352425424",
"telephone_number": "423-238-8995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "806 E JACKSON BLVD STE 15",
"city": "JONESBOROUGH",
"state": "TN",
"postal_code": "376591536",
"telephone_number": "423-753-2805"
}
],
"practiceLocations": [
{
"address_1": "4120 Waverly Rd",
"address_purpose": "LOCATION",
"city": "Huntington",
"state": "WV",
"postal_code": "257041127",
"country_code": "US",
"telephone_number": "606-324-0540",
"fax_number": "606-324-0616",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRADLEY",
"first_name": "LAKYN",
"credential": "PT DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-04",
"last_updated": "2026-09-04",
"certification_date": "2026-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "17568",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "billing@tristaterehab.com",
"affiliation": "N",
"endpointDescription": "Administrative Office",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "administrative email",
"address_1": "4120 Waverly Rd",
"city": "Huntington",
"state": "WV",
"country_code": "US",
"postal_code": "257041127",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jonesborough, TN
- Michael Shane Bermes, LCSW
- Maureen Alice Bibby, PH.D.
- Ryan David Black, BCBA
- Inger Buchanan Blanton, LCSW
- Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
- Gordon Alan Britton Jr., P.A
- Dena Lenore Brown, BCBA
- Jay Allen Burleson, D.D.S.
- Amanda A. Cantwell, NP
- Ginger Canty, MED
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.