Active NPI
Harold Bradshaw
- Behavior Analyst
- Casper, WY
National Provider Identifier
1043675432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- PMFT-278
- Practice address
- 5725 Highland Dr
Casper, WY 82609-4382 - Phone
- (307) 265-4073
- Fax
- (307) 265-2460
- NPI assigned
- Dec 29, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | PMFT-278 | WY | Primary |
Addresses
Primary practice location
5725 Highland Dr
Casper, WY 82609-4382
Mailing address
5725 Highland Dr
Casper, WY 82609-4382
Phone (307) 265-4073
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PMFT-278 | WY | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Healing Place at Highland Park Community Church | Past | Accepting new patients | |
| The Healing Place | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Counselor
- Casper, WY
- NPI 1902046949
-
- Community/Behavioral Health Agency
- Casper, WY
- NPI 1760925838
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451347200000",
"number": "1043675432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5725 HIGHLAND DR",
"city": "CASPER",
"state": "WY",
"postal_code": "826094382",
"telephone_number": "307-265-4073",
"fax_number": "307-265-2460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5725 HIGHLAND DR",
"city": "CASPER",
"state": "WY",
"postal_code": "826094382",
"telephone_number": "307-265-4073",
"fax_number": "307-265-2460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW",
"first_name": "HAROLD",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-29",
"last_updated": "2015-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WY",
"license": "PMFT-278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Casper, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.