Active NPI
Bradley Roy Noon, M.D.
- Family Medicine Physician
- Irvine, CA
National Provider Identifier
1740209014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A78661
- Practice address
- 300 Spectrum Center Dr Ste 400
Irvine, CA 92618-4989 - Phone
- (949) 216-0491
- Fax
- (949) 606-9933
- NPI assigned
- Jul 18, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Integrative Medicine Physician | 202D00000X | A78661 | CA | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | H62948 | GA | |
| Family Medicine Physician | 207Q00000X | A78661 | CA | Primary |
Addresses
Primary practice location
300 Spectrum Center Dr Ste 400
Irvine, CA 92618-4989
Mailing address
300 Spectrum Center Dr Ste 400
Irvine, CA 92618-4989
Phone (949) 216-0491
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 017732 | Other | GA | BLUE CROSS BLUE SHIELD |
| 000962794A | Medicaid | GA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H62948 | GA | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Sports Orthopedic Specialists | Sports Medicine | Current | Accepting new patients |
Locations
590 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 532-0503
1466 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone (770) 532-0503
Organizations & group practices 1
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.
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Gainesville, GA
- NPI 1053466615
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738195200000",
"number": "1740209014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 SPECTRUM CENTER DR STE 400",
"city": "IRVINE",
"state": "CA",
"postal_code": "926184989",
"telephone_number": "949-216-0491",
"fax_number": "949-606-9933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 SPECTRUM CENTER DR STE 400",
"city": "IRVINE",
"state": "CA",
"postal_code": "926184989",
"telephone_number": "949-216-0491",
"fax_number": "949-606-9933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOON",
"first_name": "BRADLEY",
"middle_name": "ROY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2025-01-30",
"certification_date": "2025-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "202D00000X",
"taxonomy_group": "",
"desc": "Integrative Medicine",
"state": "CA",
"license": "A78661",
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "GA",
"license": "H62948",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A78661",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "017732",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000962794A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.