Justin Daniel Bradish, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

14818 Issued in TX

Practice address

3950 Sunset Dr
San Angelo, TX 76904-5622

Phone

(325) 949-1600

NPI assigned

Aug 19, 2021

Last updated

Aug 19, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Angelo Back & Rehab, PA

  dba Angelo Back & Rehab

  • Chiropractor
  • San Angelo, TX
  • NPI 1760515373
  Medicare reassignment

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1932875945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 SUNSET DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 SUNSET DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045622",
            "telephone_number": "325-949-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADISH",
        "first_name": "JUSTIN",
        "middle_name": "DANIEL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-19",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "14818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delyn Boyd, OTR
• Michael Keesey Boyd, M.D.
• Frank Bedros Bozyan, MD
• Heather J. Braden, PT, MPT, PHD, GCS
• Layne M Braden, PHYSICAL THERAPIST
• Bethany Leigh Bradley, LCSW
• Brian A Bradley, MD
• Jessica Lynn Bragg, LAT, ATC
• Tiffany Branam, LCSW
• Jacob Brandon, L.A.T.

• Chiropractor in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.