Brent Bradley, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4661 Issued in OR

Practice address

18135 Cottonwood
Sunriver, OR 97707-9317

Phone

(541) 390-7518

Fax

(541) 389-6272

NPI assigned

Nov 21, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Active Care Physical Therapy Inc

  • Physical Therapist
  • Sunriver, OR
  • NPI 1801966031
  Medicare reassignment NPD Authorized official
• Healing Bridge Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Bend, OR
  • NPI 1558344531
  NPD (past)

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1811970221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 NW ITHACA AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977012113",
            "telephone_number": "541-390-7518",
            "fax_number": "541-389-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18135 COTTONWOOD",
            "city": "SUNRIVER",
            "state": "OR",
            "postal_code": "977079317",
            "telephone_number": "541-390-7518",
            "fax_number": "541-389-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "BRENT",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183072",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harvey A Abrams, MD
• Active Care Physical Therapy Inc
• Douglas W Anderson, DMD
• Robin Elizabeth Arnett, LCSW
• Jennifer Betuk
• Caldera Physical Therapy LLC
• Erin-Rae Cook, LMT
• Stefan D'Auteuil
• Daniel M Skotte DO PC
• Carlee Nicole Demore

• Physical Therapist in Sunriver, OR
• Providers in Sunriver, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.