Courtney Bradac

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT019180 Issued in OH

Practice address

8836 Tyler Blvd
Mentor, OH 44060-4361

Phone

(440) 255-9553

NPI assigned

Aug 9, 2021

Sex

Female

Sole proprietor

Yes

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 OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cardinal Physical Therapy and Rehabilitation, LLC

  • Physical Therapist
  • Chesterland, OH
  • NPI 1427326644
  Medicare reassignment NPD
• Tudor Home Therapies Inc

  • Physical Therapist
  • Austintown, OH
  • NPI 1295783389
  Medicare reassignment NPD

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1710651179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 GARDEN RD",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440947317",
            "telephone_number": "440-975-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8836 TYLER BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604361",
            "telephone_number": "440-255-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADAC",
        "first_name": "COURTNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT019180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorreta Boykin, MSSA, LISW
• Patrick T Boylan, MD
• Kenneth Andrew Boyle Sr., OD
• James Matthew Bozic, O.D.
• Laura B Bracknell, DO
• Barry Rex Bradford, D.C.
• Bradley Johnson D.M.D., M.S.D., LLC
• Ariel E. Braff, QMHS
• Megan Branstein
• Catharine Brasdovich, LPC

• Physical Therapist in Mentor, OH
• Providers in Mentor, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.