Bradley D. Richards, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5000567-1206 Issued in UT

Practice address

3584 W 9000 S Ste 305
West Jordan, UT 84088-4775

Phone

(801) 992-1233

Fax

(385) 301-5544

NPI assigned

Aug 15, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bradley.richards@551970662645764.direct.elationemr.com

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.

• Granger Medical Specialists LLC

  • Clinic/Center
  • West Valley City, UT
  • NPI 1376159368
  NPD (past)

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1790931210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3584 W 9000 S STE 305",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840884775",
            "telephone_number": "801-992-1233",
            "fax_number": "385-301-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3584 W 9000 S STE 305",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840884775",
            "telephone_number": "801-992-1233",
            "fax_number": "385-301-5544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12391 S 4000 W",
            "address_purpose": "LOCATION",
            "city": "Riverton",
            "state": "UT",
            "postal_code": "840967012",
            "country_code": "US",
            "telephone_number": "801-302-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Tilbury Drive",
            "address_purpose": "LOCATION",
            "city": "Kearny",
            "state": "AZ",
            "postal_code": "851370110",
            "country_code": "US",
            "telephone_number": "520-363-5573",
            "fax_number": "520-363-5611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "BRADLEY",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4827",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "5000567-1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "614642",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Simmons Reyes
• Elena Ramirez Reyes
• RGL Medical Services LLC
• RGL Medical Services LLC
• Richard E Lambert MD, PC
• Christine Adams Richards, LCSW
• Eryn Richards
• Kateri N Richins, ACMHC
• Jiraa Riding
• Bradley S Rigby, DMD

• Physician Assistant in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.