Tannon Bradley, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

13442708-9934 Issued in UT

Practice address

1355 N University Ave Ste 100
Provo, UT 84604-2721

Phone

(801) 377-4333

NPI assigned

Jun 8, 2023

Sex

Male

Sole proprietor

Yes

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 UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Utah Valley Optometric PhysiciansGroup PAC ID 1658274899, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

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.

• Utah Valley Optometric Physicians

  • Optometrist
  • Springville, UT
  • NPI 1760545735
  Medicare reassignment Care Compare group NPD
• Frank a Siddoway OD PC

  • Optometrist
  • Provo, UT
  • NPI 1073786505
  NPD (past)

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1972297109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 N UNIVERSITY AVE STE 100",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042721",
            "telephone_number": "801-377-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 N UNIVERSITY AVE STE 100",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042721",
            "telephone_number": "801-377-4333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "374 E 400 S Ste 1",
            "address_purpose": "LOCATION",
            "city": "Springville",
            "state": "UT",
            "postal_code": "846631975",
            "country_code": "US",
            "telephone_number": "801-489-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "TANNON",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "13442708-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Andrew Bradford
• Madisson Bradford, LCSW
• Rachel Bradford
• Russell D Bradford, M.D.
• Arianna Amy Bradley-Roth, MSW, CSW
• Braden David Bradshaw
• Brian R Bradshaw, MD
• Kaydon Robert Bradshaw
• Eric J Brady, D.C.
• Jared Perry Brady, DPT

• Optometrist in Provo, UT
• Providers in Provo, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.