Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackson Miles Bradford, PA

Individual provider Physician Assistant · NPI 1477314003

Jackson Miles Bradford, PA is a Physician Assistant in American Fork, Utah. Qualified in 2024, 2 years ago. Practices with Revere Health PC, a 410-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
2
Licensed in
UT
In the registry since
2024
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1175 E 50 S Ste 221
American Fork, UT 84003-2845
Phone: (801) 772-0775
Fax: (801) 772-1941
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 14078197-1206 (UT)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1477314003
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 22, 2024
Last updated in NPPESDecember 18, 2024
Certification dateDecember 18, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in American Fork