Active NPI
Bradley Brown, ATC
- Prevention Professional
- Lincoln, NE
National Provider Identifier
1790225076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- 74
- Practice address
- 1 Memorial Stadium Dr
Athletic Medicine Dept.
Lincoln, NE 68588-0031 - Phone
- (402) 472-4382
- NPI assigned
- Mar 6, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prevention Professional | 405300000X | 74 | NE | Primary |
Addresses
Primary practice location
1 Memorial Stadium Dr
Athletic Medicine Dept.
Lincoln, NE 68588-0031
Mailing address
1 Memorial Stadium Dr
Athletic Medicine Dept.
Lincoln, NE 68588-0031
Phone (402) 472-4382
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
| License | State | Type | Specialty |
|---|---|---|---|
| 74 | NE | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488758400000",
"number": "1790225076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MEMORIAL STADIUM DR",
"address_2": "ATHLETIC MEDICINE DEPT.",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685880031",
"telephone_number": "402-472-4382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEMORIAL STADIUM DR",
"address_2": "ATHLETIC MEDICINE DEPT.",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685880031",
"telephone_number": "402-472-4382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "BRADLEY",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-06",
"last_updated": "2017-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "NE",
"license": "74",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.