Active NPI
Landon Hope Bradford, ATC
- Athletic Trainer
- Flagstaff, AZ
National Provider Identifier
1235142779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0370
- Practice address
- 1705 South San Francisco Street
Student Athlete High Performance Center
Flagstaff, AZ 86011 - Phone
- (928) 523-5469
- NPI assigned
- Aug 15, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096.002701 | IL | |
| Athletic Trainer | 2255A2300X | 0370 | AZ | Primary |
Addresses
Primary practice location
1705 South San Francisco Street
Student Athlete High Performance Center
Flagstaff, AZ 86011
Mailing address
1705 South San Francisco Street
Student Athlete High Performance Center
Flagstaff, AZ 86011
Phone (928) 523-5469
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 |
|---|---|---|---|
| 0370 | AZ | MD | Physical Therapist |
| 096.002701 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736726400000",
"number": "1235142779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1705 SOUTH SAN FRANCISCO STREET",
"address_2": "STUDENT ATHLETE HIGH PERFORMANCE CENTER",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "86011",
"telephone_number": "928-523-5469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 SOUTH SAN FRANCISCO STREET",
"address_2": "STUDENT ATHLETE HIGH PERFORMANCE CENTER",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "86011",
"telephone_number": "928-523-5469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADFORD",
"first_name": "LANDON",
"middle_name": "HOPE",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2025-01-13",
"certification_date": "2025-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096.002701",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AZ",
"license": "0370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.