Active NPI
Devin Bradshaw, DO
- Pulmonary Disease Physician
- Las Vegas, NV
National Provider Identifier
1104445311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- DO3290
- Practice address
- 620 Shadow LN
Las Vegas, NV 89106-4119 - Phone
- (702) 477-6572
- NPI assigned
- Apr 9, 2020
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | DO3290 | NV | Primary |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | DO3290 | NV | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | DO3290 | NV |
Addresses
Primary practice location
620 Shadow LN
Las Vegas, NV 89106-4119
Mailing address
620 Shadow LN
Las Vegas, NV 89106-4119
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200727002128 | NV | Order and Referring Only - Critical Care (Intensivists) | 2961826730 |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Pacific NW Un of HS, Col of Osteopathic Medicine, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
601 County Rd
Suite 904
Joshua, TX 76058
PO Box
Dallas, TX 75261
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO3290 | NV | MD | Internal Medicine Physician |
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Las Vegas, NV
- NPI 1417947490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775865600000",
"number": "1104445311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 SHADOW LN",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 SHADOW LN",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064119",
"telephone_number": "702-477-6572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW",
"first_name": "DEVIN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-09",
"last_updated": "2026-04-11",
"certification_date": "2026-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NV",
"license": "DO3290",
"primary": true
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NV",
"license": "DO3290",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NV",
"license": "DO3290",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.