Active NPI
Bradley Hanson, PTA
- Physical Therapist
- Glen Burnie, MD
National Provider Identifier
1912835869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 31017
- Practice address
- 1413 Madison Park Dr Ste 100
Glen Burnie, MD 21061-6355 - Phone
- (443) 969-7119
- NPI assigned
- May 11, 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 31017 | MD | Primary |
Addresses
Primary practice location
1413 Madison Park Dr Ste 100
Glen Burnie, MD 21061-6355
Mailing address
713 Baylor Rd
Glen Burnie, MD 21061-4653
Phone (410) 562-1910
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 |
|---|---|---|---|
| A4750 | MD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1778457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787097600000",
"number": "1912835869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "713 BAYLOR RD",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210614653",
"telephone_number": "410-562-1910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1413 MADISON PARK DR STE 100",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210616355",
"telephone_number": "443-969-7119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "BRADLEY",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-05-11",
"last_updated": "2026-08-19",
"certification_date": "2026-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "31017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Burnie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.