Todd A. Bradley, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

02500 Issued in IA

Practice address

204 E Charles St
Oelwein, IA 50662-1940

Phone

(319) 283-2002

Fax

(319) 283-2015

NPI assigned

Dec 2, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Performance Rehab LLCGroup PAC ID 4486712619, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Performance Rehab LLC

  • Physical Therapist
  • Oelwein, IA
  • NPI 1811052350
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1851469100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E CHARLES ST",
            "city": "OELWEIN",
            "state": "IA",
            "postal_code": "506621940",
            "telephone_number": "319-283-2002",
            "fax_number": "319-283-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E CHARLES ST",
            "city": "OELWEIN",
            "state": "IA",
            "postal_code": "506621940",
            "telephone_number": "319-283-2002",
            "fax_number": "319-283-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "TODD",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-02",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "02500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00709294",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811052350",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "1811052350",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyla Danielle Bentley, DPT
• Sara Ann Berns, PA-C
• Berryman Family Dentistry, Inc.
• Clinton Thomas Berryman, DDS
• Adria Booth-Tyler
• Brown Chiropractic PC
• Bradley J Brown, DC
• Douglas Bulman
• Erica L Bushaw, PHARMD
• Brianne Connie Byerly

• Physical Therapist in Oelwein, IA
• Providers in Oelwein, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.