Shenan Bradshaw DDS MD PA

A Medicare group practice based in Greensboro, NC: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 3779007711), with 4 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
3779007711The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part B Supplier - Clinic/Group Practice
Enrolled in
NC
Enrollments
2
Group size
4 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
3In 2 places

Enrollment records 2

Enrollment IDStateProvider typeNPI
O20250410003327 NC Part B Supplier - Clinic/Group Practice 1952315301
O20250925000948 NC Part B Supplier - Clinic/Group Practice 1114710472

NPIs in this group 2

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 4

Clinicians who reassign their Medicare benefits to this group (4) or whom Care Compare lists as members (4).

Sources for this page