Active NPI
Bradley J Davidson, PT
- Physical Therapist
- Frenchburg, KY
National Provider Identifier
1689616658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 004717
- Practice address
- 814 Highway 36
Frenchburg, KY 40322-8124 - Phone
- (606) 393-0953
- NPI assigned
- Jun 12, 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 004717 | KY | Primary |
Addresses
Primary practice location
814 Highway 36
Frenchburg, KY 40322-8124
Mailing address
15 Apex Dr
Highland, IL 62249-1282
Phone (618) 441-0482
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000333709 | Other | KY | BC HPTA |
| 000000199364 | Other | KY | BC OF PARIS |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Rehabilitation Associates, PSC | Physical Therapist | Past | Accepting new patients |
| Agilitas USA Inc | Past | Accepting new patients | |
| Integrity Diagnostics, PLLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Louisville, KY
- NPI 1609117811
-
- Clinical Electrophysiology Physical Therapist
- Richmond, KY
- NPI 1275128563
Physical Therapist
-
- Physical Therapist
- Richmond, KY
- NPI 1669463170
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496102400000",
"number": "1689616658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 APEX DR",
"city": "HIGHLAND",
"state": "IL",
"postal_code": "622491282",
"telephone_number": "618-441-0482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "814 HIGHWAY 36",
"city": "FRENCHBURG",
"state": "KY",
"postal_code": "403228124",
"telephone_number": "606-393-0953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "BRADLEY",
"middle_name": "J",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2017-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "004717",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC HPTA",
"identifier": "000000333709",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC OF PARIS",
"identifier": "000000199364",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Frenchburg, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.