Active NPI
Gregory Maurice Bradley Jr., LMBT, MMP
- Massage Therapist
- Huntersville, NC
National Provider Identifier
1841423456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 20138
- Practice address
- 16501 Northcross Dr Ste D
Huntersville, NC 28078-5040 - Phone
- (980) 222-4787
- NPI assigned
- Aug 29, 2009
- Last updated
- Nov 21, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 20138 | NC | |
| Massage Therapist | 225700000X | 20138 | NC | Primary |
Addresses
Primary practice location
16501 Northcross Dr Ste D
Huntersville, NC 28078-5040
Mailing address
7541 Pilot Cove CT
Denver, NC 28037-9450
Phone (704) 578-7365
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 |
|---|---|---|---|
| 20138 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732147200000",
"number": "1841423456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7541 PILOT COVE CT",
"city": "DENVER",
"state": "NC",
"postal_code": "280379450",
"telephone_number": "704-578-7365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16501 NORTHCROSS DR STE D",
"city": "HUNTERSVILLE",
"state": "NC",
"postal_code": "280785040",
"telephone_number": "980-222-4787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "GREGORY",
"middle_name": "MAURICE",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LMBT, MMP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-29",
"last_updated": "2024-11-21",
"certification_date": "2024-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "NC",
"license": "20138",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "20138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntersville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.