Active NPI
Jeanne Jokinen Bradshaw, PT, OCS
- Physical Therapist
- Boone, NC
National Provider Identifier
1043402159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6012
- Practice address
- 232 Boone Heights Dr
Suite a
Boone, NC 28607-4926 - Phone
- (828) 262-9043
- Fax
- (828) 268-9045
- NPI assigned
- Aug 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6012 | NC | Primary |
Addresses
Primary practice location
232 Boone Heights Dr
Suite a
Boone, NC 28607-4926
Mailing address
PO Box 2600
Boone, NC 28607-2600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3400051 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6012 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186963200000",
"number": "1043402159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2600",
"city": "BOONE",
"state": "NC",
"postal_code": "286072600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "232 BOONE HEIGHTS DR",
"address_2": "SUITE A",
"city": "BOONE",
"state": "NC",
"postal_code": "286074926",
"telephone_number": "828-262-9043",
"fax_number": "828-268-9045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW",
"first_name": "JEANNE",
"middle_name": "JOKINEN",
"credential": "PT, OCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-13",
"last_updated": "2007-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "6012",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3400051",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boone, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.