Active NPI
Joshua Bradley, ATC
- Athletic Trainer
- Boise, ID
National Provider Identifier
1649970674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000051184
- Practice address
- 6051 W Emerald St
Boise, ID 83704 - Phone
- (208) 302-5150
- NPI assigned
- Mar 8, 2023
- Last updated
- Mar 8, 2023
- 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 | 2000051184 | ID | Primary |
Addresses
Primary practice location
6051 W Emerald St
Boise, ID 83704
Mailing address
6975 W. Preece Lane
Apt 102
Boise, ID 83704
Phone (425) 269-5885
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 |
|---|---|---|---|
| 2000051184 | ID | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678233600000",
"number": "1649970674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6975 W. PREECE LANE",
"address_2": "APT 102",
"city": "BOISE",
"state": "ID",
"postal_code": "83704",
"telephone_number": "425-269-5885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6051 W EMERALD ST",
"city": "BOISE",
"state": "ID",
"postal_code": "83704",
"telephone_number": "208-302-5150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "JOSHUA",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-08",
"last_updated": "2023-03-08",
"certification_date": "2023-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ID",
"license": "2000051184",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.