Individual provider Active NPI

Kirk Thomas Bradley, PT,DPT, M.S., ATC

  • Ergonomics Physical Therapist
  • Stockton, CA
National Provider Identifier
1205926938
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ergonomics Physical TherapistTaxonomy code 2251E1200X
License
PT 23700 Issued in CA
Practice address
2105 W March LN Ste 3
Stockton, CA 95207-6407
Phone
(209) 951-3265
Fax
(209) 351-3285
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 23700 CA
Ergonomics Physical Therapist 2251E1200X PT 23700 CA Primary

Addresses

Primary practice location

2105 W March LN Ste 3
Stockton, CA 95207-6407

Mailing address

13976 E Sparrow Hawk Dr
Lockeford, CA 95237-9545
Phone (209) 727-5594

Other identifiers 1

IdentifierTypeStateIssuer
PT0237000MedicaidCA

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
23700CAMDDentist
PT 23700CAMDErgonomics Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Body Dynamics Physical Therapy Inc Physical Therapist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1205926938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13976 E SPARROW HAWK DR",
            "city": "LOCKEFORD",
            "state": "CA",
            "postal_code": "952379545",
            "telephone_number": "209-727-5594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 W MARCH LN STE 3",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076407",
            "telephone_number": "209-951-3265",
            "fax_number": "209-351-3285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "KIRK",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PT,DPT, M.S., ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 23700",
            "primary": false
        },
        {
            "code": "2251E1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Ergonomics",
            "state": "CA",
            "license": "PT 23700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT0237000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.