Active NPI
Mark Stephen Bradley, OD
- Optometrist
- Trayerise City, MI
National Provider Identifier
1841269040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901003660
- Practice address
- 322 E Front St
Trayerise City, MI 49684 - Phone
- (231) 933-4788
- Fax
- (231) 933-4845
- NPI assigned
- Mar 17, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901003660 | MI | Primary |
Addresses
Primary practice location
322 E Front St
Trayerise City, MI 49684
Mailing address
322 E Front St
Trayerise City, MI 49684
Phone (231) 933-4788
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 |
|---|---|---|---|
| 4901003660 | MI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kent Vision Centers Inc | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1841269040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 E FRONT ST",
"city": "TRAYERISE CITY",
"state": "MI",
"postal_code": "49684",
"telephone_number": "231-933-4788",
"fax_number": "231-933-4845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "322 E FRONT ST",
"city": "TRAYERISE CITY",
"state": "MI",
"postal_code": "49684",
"telephone_number": "231-933-4788",
"fax_number": "231-933-4845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "MARK",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901003660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.