NPIMap

Organization Active NPI

Bradley Physical Therapy Clinic, Inc.

  • Specialist
  • Washington, PA
National Provider Identifier
1447208046
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
DAPT000038 Issued in PA
Legal business name
BRADLEY PHYSICAL THERAPY CLINIC, INC.
Practice address
382 W Chestnut St
Washington, PA 15301-4642
Phone
(724) 228-2911
NPI assigned
May 5, 2006
Last updated
May 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Authorized official

Name
Dr. David M Bradley, DPTNPI 1093708521
Title
Director
Phone
(724) 228-2911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X DAPT000038 PA Primary

Addresses

Primary practice location

382 W Chestnut St
Washington, PA 15301-4642

Mailing address

382 W Chestnut St
Washington, PA 15301-4642

Other identifiers 1

IdentifierTypeStateIssuer
680883OtherPAKEYSTONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030804000000 PA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 5597676296 Practice locations: Canonsburg, PA; Washington, PA
O20071012000014 PA Part B Supplier - Clinic/Group Practice 5597676296 Receives reassigned benefits from 7 practitioners
Practice locations: Canonsburg, PA; Washington, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447208046. Details of each certification follow.

  • CCN 396687 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 396687

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BRADLEY PHYSICAL THERAPY CLINIC INC
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Aug 18, 1994
Last certification
Nov 21, 2019
Ownership / control type
Proprietary
Facility address
382 West Chestnut Street Suite 201
Washington, PA 15301

National Provider Directory

National Provider Directory

Locations

1001 Corporate Dr
Ste 110
Canonsburg, PA 15317
Phone (724) 746-2782

1001 Corporate Dr
Ste 125
Canonsburg, PA 15317
Phone (724) 746-2782

333 Technology Dr
Ste 116
Canonsburg, PA 15317
Phone (412) 407-2434

382 W Chestnut St
Washington, PA 15301
Phone (724) 225-1221

382 W Chestnut St
Ste 201
Washington, PA 15301
Phone (724) 228-2911

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463616000000",
    "number": "1447208046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 W CHESTNUT ST",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153014642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 W CHESTNUT ST",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153014642",
            "telephone_number": "724-228-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY PHYSICAL THERAPY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2016-05-19",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "724-228-2911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "DAPT000038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "680883",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, PA

Sources for this page

Verify at the official NPI Registry.