Grace Katherine Bradtke, MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0126002710 Issued in VA

Practice address

1115 Boulders Pkwy Ste 110
North Chesterfield, VA 23225-4067

Phone

(804) 560-6517

NPI assigned

Feb 2, 2018

Last updated

Feb 2, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Grace Katherine Giles Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517529600000",
    "number": "1427557693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 MENDOTA DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232293345",
            "telephone_number": "804-523-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BOULDERS PKWY STE 110",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232254067",
            "telephone_number": "804-560-6517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADTKE",
        "first_name": "GRACE",
        "middle_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-02",
        "last_updated": "2018-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126002710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "GILES",
            "middle_name": "KATHERINE",
            "prefix": "MISS",
            "credential": "MS, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Elizabeth Bradley, DPT
• Michael Bradley
• Brian Thomas Bradshaw, M.D.
• Branches of Life Healing Center LLC
• Brandsync Benefit Corporation
• Bailey Marie Brannon, OTR/L
• Cindy Braxton
• Breaking the Cycle, LLC

• Athletic Trainer in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Athletic Trainer in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; 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.