Bradley J Gardner, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1484 Issued in NE

Practice address

308 N Central Ave
Superior, NE 68978-1715

Phone

(402) 879-0109

Fax

(866) 764-0606

NPI assigned

Feb 27, 2008

Last updated

Jan 7, 2020By the provider in NPPES

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 NE

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Nebraska College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Superior Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Superior, NE
  • NPI 1275905689
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1821267550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 263",
            "city": "SUPERIOR",
            "state": "NE",
            "postal_code": "689780263",
            "telephone_number": "402-879-0109",
            "fax_number": "866-764-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 N CENTRAL AVE",
            "city": "SUPERIOR",
            "state": "NE",
            "postal_code": "689781715",
            "telephone_number": "402-879-0109",
            "fax_number": "866-764-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "BRADLEY",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-27",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "1102973",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisha Fangmeyer, APRN
• Nikki Renae Felmlee
• Steve Abe Fox, C.R.N.A.
• Teresa B Frahm, NP
• Charles Fullerton
• Matthew Gatlin, PA-C
• Belinda Genung
• Faith Gilligan
• Kayla M Golay
• Jodi Grabast, M.S., CCC-SLP

• Physical Therapist in Superior, NE
• Providers in Superior, NE by specialty
• Physical Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.