Michelle Jene Bradshaw

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT002590 Issued in GA

Practice address

116 Forrest Ave
Cartersville, GA 30120-3640

Phone

(770) 382-3206

Fax

(770) 382-3276

NPI assigned

Nov 14, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cathleen Shepherd

  • Occupational Therapist
  • Cartersville, GA
  • NPI 1841355898
  NPD (past)
• Stepping Stones Pediatric Therapy, LLC

  • Pediatric Occupational Therapist
  • Chandler, AZ
  • NPI 1124014253
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053483016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6027 ARMOR DR",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301276244",
            "telephone_number": "770-422-2512",
            "fax_number": "770-434-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 FORREST AVE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301203640",
            "telephone_number": "770-382-3206",
            "fax_number": "770-382-3276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "MICHELLE",
        "middle_name": "JENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT002590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "52171843 001",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10035964",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "52171843 003",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "312667",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "52171843 002",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Bonk, LMFT
• Jovas C. Booker, D.M.D
• Alexandria Boss
• James A Boutselis, PA-C
• Michelle Bowers
• Kunal Brahmbhatt
• Lynn Michele Brandt, NP
• Louisa Porter Branscomb, PH.D.
• Jeffrey R Brant, MD
• Melissa Breed, CCC-SLP

• Occupational Therapist in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.