Bradley Jon Gardner (NPI# 1821267550, PAC ID# 8729389028) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
Nation Provider ID (NPI) | 1821267550 |
PAC ID by PECOS | 8729389028 |
Professional Enrollment ID | I20151210000709 |
Full Name | Bradley Jon Gardner |
Organization Legal Name | SUPERIOR PHYSICAL THERAPY LLC |
Address |
308 N Central Ave Superior NE 68978-1715 |
Phone Number | 4028790109 |
Gender | M |
Medical School | UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE |
Graduation Year | 1996 |
Primary Specialty | PHYSICAL THERAPY |
Group Practice PAC ID | 7810298114 |
Number of Group Practice Members | 2 |
Accepts Medicare Assignment | Y |
Address | Phone | Organization |
---|---|---|
308 N Central Ave, Superior, NE 68978-1715 | 4028790109 | SUPERIOR PHYSICAL THERAPY LLC |
Organization Legal Name | SUPERIOR PHYSICAL THERAPY LLC |
Physicians | 2 |
Name | Specialty | Organization | Address |
---|---|---|---|
Holly L Beavers | Physical Therapy | Superior Physical Therapy LLC | 308 N Central Ave, Superior, NE 68978-1715 |
Street Address |
308 N CENTRAL AVE |
City | SUPERIOR |
State | NE |
Zip | 68978-1715 |
Name | Specialty | Organization | Address |
---|---|---|---|
Holly L Beavers | Physical Therapy | Superior Physical Therapy LLC | 308 N Central Ave, Superior, NE 68978-1715 |
Name | Specialty | Organization | Address |
---|---|---|---|
Julie A Theis | Family Medicine | Brodstone Memorial Hospital | 520 E 10th St, Superior, NE 68978-1225 |
Alisha Fangmeyer | Nurse Practitioner | Brodstone Memorial Hospital | 520 E 10th St, Superior, NE 68978-1225 |
Robert G Leibel | Family Medicine | Brodstone Memorial Hospital | 520 E 10th St, Superior, NE 68978-1225 |
Timothy D Blecha | Family Medicine | Brodstone Memorial Hospital | 520 E 10th St, Superior, NE 68978-1225 |
Jason G Hass | Physician Assistant | Brodstone Memorial Hospital | 520 E 10th St, Superior, NE 68978-1225 |
Jeremy W Mcmeen | Optometry | 358 N Central Ave, Superior, NE 68978-1715 | |
Peggy A Meyer | Clinical Social Worker | 317 N Central Ave, Superior, NE 68978-1737 |
City | SUPERIOR |
Zip Code | 68978 |
Specialty | PHYSICAL THERAPY |
City + Specialty | SUPERIOR + PHYSICAL THERAPY |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.