Individual provider Active NPI

Bradley Roy Noon, M.D.

  • Family Medicine Physician
  • Irvine, CA
National Provider Identifier
1740209014
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A78661 Issued in CA
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

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
017732OtherGABLUE CROSS BLUE SHIELD
000962794AMedicaidGA

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

LicenseStateTypeSpecialty
H62948GAMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Sports Orthopedic Specialists Sports Medicine CurrentSince Jun 18, 2002 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.

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.

Verify at the official NPI Registry.