Active NPI
Bradley William Garrett, PTA
- Physical Therapy Assistant
- Henderson, KY
National Provider Identifier
1285964957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A02491
- Practice address
- 1024 N Elm St
Henderson, KY 42420-2713 - Phone
- (270) 724-9120
- NPI assigned
- Jan 2, 2010
- Last updated
- Jan 2, 2010
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A02491 | KY | Primary |
| Physical Therapy Assistant | 225200000X | 06002965A | IN |
Addresses
Primary practice location
1024 N Elm St
Henderson, KY 42420-2713
Mailing address
1024 N Elm St
Henderson, KY 42420-2713
Phone (270) 724-9120
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 |
|---|---|---|---|
| 06002965A | IN | MD | Physical Therapy Assistant |
| A02491 | KY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262390400000",
"number": "1285964957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1024 N ELM ST",
"city": "HENDERSON",
"state": "KY",
"postal_code": "424202713",
"telephone_number": "270-724-9120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1024 N ELM ST",
"city": "HENDERSON",
"state": "KY",
"postal_code": "424202713",
"telephone_number": "270-724-9120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARRETT",
"first_name": "BRADLEY",
"middle_name": "WILLIAM",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-01-02",
"last_updated": "2010-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KY",
"license": "A02491",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IN",
"license": "06002965A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Henderson, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.