Bradford Collett, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-6829 Issued in ID

Practice address

1739 S Jade Way Ste 100
Meridian, ID 83642-4464

Phone

(208) 207-5454

Fax

(208) 600-6064

NPI assigned

Mar 9, 2021

Last updated

Mar 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Achieve Physical Therapy PLLC

  • Physical Therapist
  • Boise, ID
  • NPI 1659540995
  Medicare reassignment NPD
• The Villages Rehabilitation Services LLC

  dba Lake Centre for Rehabilitation at the Villages

  • Rehabilitation Clinic/Center
  • Lady Lake, FL
  • NPI 1407922735
  NPD (past)

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1679168801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 FALLS AVE E STE 401",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013455",
            "telephone_number": "208-969-9945",
            "fax_number": "208-944-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 S JADE WAY STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424464",
            "telephone_number": "208-207-5454",
            "fax_number": "208-600-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETT",
        "first_name": "BRADFORD",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-09",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-6829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa L Cole, PHARMD
• Lance Wayne Coleman, MD
• Josh Coles
• Brock Coletti
• Colleran Consulting LLC (Still Waters Wellness)
• Brandie Dawn Collins, PA
• Carolyn Collins, M.S. CCC-SLP
• Paul Calvin Collins, M.D.
• Isabel Marie Colquhoun
• Courtney M Combe, PA-C

• Physical Therapist in Meridian, ID
• Providers in Meridian, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.