Active NPI
Bradley V Bluestone, ATC
- Athletic Trainer
- Louisville, KY
National Provider Identifier
1619088861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT142
- Practice address
- 2001 Newburg Rd
Louisville, KY 40205-1863 - Phone
- (502) 272-8379
- NPI assigned
- Aug 31, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT142 | KY | Primary |
Addresses
Primary practice location
2001 Newburg Rd
Louisville, KY 40205-1863
Mailing address
10305 Cooperwood CT
Louisville, KY 40229-2276
Phone (502) 969-4310
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 |
|---|---|---|---|
| AT142 | KY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354752000000",
"number": "1619088861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10305 COOPERWOOD CT",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402292276",
"telephone_number": "502-969-4310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 NEWBURG RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402051863",
"telephone_number": "502-272-8379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUESTONE",
"first_name": "BRADLEY",
"middle_name": "V",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2012-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "KY",
"license": "AT142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.