Gus Bradford

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

3601 Minnesota Dr Ste 600
Edina, MN 55435-5248

Phone

(952) 851-8200

NPI assigned

May 7, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Physicians Neck & Back Clinics

  • Physical Medicine & Rehabilitation Physician
  • Roseville, MN
  • NPI 1538495247
  NPD

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1841874609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4145 PARKLAWN AVE APT 222",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354648",
            "telephone_number": "952-851-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 MINNESOTA DR STE 600",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355248",
            "telephone_number": "952-851-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "GUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "gustav.x.bradford@pnbconline.com",
            "affiliation": "N",
            "address_1": "3601 Minnesota Dr Ste 600",
            "city": "Edina",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554355248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jess Boysen, M.D.
• Matthew Robert Braasch, M.D.
• Michael Braaton, MD
• Gordon A Braatz, PH.D.
• Timothy P. Braatz, M.D.
• Bradley Management LLC
• Jamie Bradley
• Marketa Bradley, RCP
• Heidi Marie Brandenburg, DDS
• Hegel Gonzales Brandes, DPT

• Physical Therapy Assistant in Edina, MN
• Providers in Edina, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.