Active NPI
Martyn H Bradley, ATC
- Athletic Trainer
- Norfolk, VA
National Provider Identifier
1376889774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0126000010
- Practice address
- L R Hill Sports Complex
Norfolk, VA 23529-0001 - Phone
- (757) 683-3840
- NPI assigned
- Dec 13, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0126000010 | VA | Primary |
Addresses
Primary practice location
L R Hill Sports Complex
Norfolk, VA 23529-0001
Mailing address
5303 Rolfe Ave
Norfolk, VA 23508-1356
Phone (757) 777-7524
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 |
|---|---|---|---|
| 0126000010 | VA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355356800000",
"number": "1376889774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5303 ROLFE AVE",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235081356",
"telephone_number": "757-777-7524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "L R HILL SPORTS COMPLEX",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235290001",
"telephone_number": "757-683-3840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "MARTYN",
"middle_name": "H",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-12-13",
"last_updated": "2012-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "VA",
"license": "0126000010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.