Active NPI
John Hamlin Bradley, OTR/L
- Occupational Therapist
- Mansfield, OH
National Provider Identifier
1174869242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-003092
- Practice address
- 255 Hedges Street
Suite a
Mansfield, OH 44902 - Phone
- (419) 774-4290
- Fax
- (419) 774-4375
- NPI assigned
- Dec 18, 2012
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT-003092 | OH | Primary |
Addresses
Primary practice location
255 Hedges Street
Suite a
Mansfield, OH 44902
Mailing address
255 Hedges Street
Suite a
Mansfield, OH 44902
Phone (419) 774-4290
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2905593 | Medicaid | OH |
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 |
|---|---|---|---|
| OT-003092 | OH | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355788800000",
"number": "1174869242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 HEDGES STREET",
"address_2": "SUITE A",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "44902",
"telephone_number": "419-774-4290",
"fax_number": "419-774-4375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 HEDGES STREET",
"address_2": "SUITE A",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "44902",
"telephone_number": "419-774-4290",
"fax_number": "419-774-4375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "JOHN",
"middle_name": "HAMLIN",
"name_prefix": "Mr.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-18",
"last_updated": "2012-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT-003092",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2905593",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.