Individual provider Active NPI

Bradley Petersen, PT, DPT

  • Physical Medicine & Rehabilitation Physician
  • Louisville, KY
National Provider Identifier
1780513416
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
TP2026019 Issued in KY
Practice address
9400 Williamsburg PLZ Ste 100
Louisville, KY 40222-5097
Phone
(502) 412-4486
Fax
(502) 412-4490
NPI assigned
May 18, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X TP2026019 KY Primary

Addresses

Primary practice location

9400 Williamsburg PLZ Ste 100
Louisville, KY 40222-5097

Mailing address

9400 Williamsburg PLZ Ste 100
Louisville, KY 40222-5097
Phone (502) 412-4486

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TP2026019KYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopaedic Physical Therapy, PSC PastSince Nov 27, 2000 Accepting new patients

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": "1779062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1780513416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 WILLIAMSBURG PLZ STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225097",
            "telephone_number": "502-412-4486",
            "fax_number": "502-412-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 WILLIAMSBURG PLZ STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225097",
            "telephone_number": "502-412-4486",
            "fax_number": "502-412-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "BRADLEY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-18",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "KY",
            "license": "TP2026019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; 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.