Bradley Hambleton Whitley, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

297201 Issued in CA

Practice address

2690 Via de la Valle Ste D160
Del Mar, CA 92014-1991

Phone

(509) 294-5289

NPI assigned

Jul 31, 2017

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bespoke San Diego Physical Therapy PCGroup PAC ID 7012388168, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bespoke San Diego Physical Therapy PC

  • Physical Therapy Clinic/Center
  • San Diego, CA
  • NPI 1245847540

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1811411960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5653 RILEY ST APT 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102567",
            "telephone_number": "509-294-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 VIA DE LA VALLE STE D160",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920141991",
            "telephone_number": "509-294-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "BRADLEY",
        "middle_name": "HAMBLETON",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60768679",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Elizabeth Watson, M.D.
• Shelby Weaver, RD
• S Scott Weiner, PH.D., J.D.
• Susan Beth Weinstock, MD
• Diana Karen Weiss, PH.D.
• Tracy Whynot, L.AC
• William E. Lerner Chiropractic, Inc.
• Joan W Winchell, MFT
• Winfield Dental Group, LLC
• Wink Optometry & Eyewear, Inc

• Physical Therapist in Del Mar, CA
• Providers in Del Mar, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.