Individual provider Active NPI

Whitney Bradshaw, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1104454701
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R209524 Issued in MD
Practice address
100 E Carroll St
Salisbury, MD 21801-5422
Phone
(410) 543-7162
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R209524 MD Primary

Addresses

Primary practice location

100 E Carroll St
Salisbury, MD 21801-5422

Mailing address

35334 Tingle Rd
Willards, MD 21874-1323
Phone (443) 235-0491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210323000050 MD Practitioner - Nurse Practitioner 9931516705 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Worcester County Health Department 23 clinicians

Practice addresses (Care Compare)

9730 Healthway Dr
Berlin, MD 21811-1154
Phone (410) 629-0164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R209524MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic General Hospital Corporation CurrentSince Nov 1, 2023 Accepting new patients
Worcester County Health Department CurrentSince May 19, 2021 Accepting new patients
Worcester County Health Department Current Accepting new patients
The Personal Wellness Center CurrentSince Sep 14, 2022 Accepting new patients
Arman C. Moshyedi, MD, LLC CurrentSince Apr 6, 2022 Accepting new patients
Tidalhealth Atlantic, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Tidalhealth Specialty Care, LLC CurrentSince Mar 1, 2026 Accepting new patients
Worcester County Health Department CurrentSince May 19, 2021 Accepting new patients

Locations

900 Bestgate Rd
Ste 102
Annapolis, MD 21401
Phone (443) 354-1200

9733 Healthway Dr
Berlin, MD 21811
Phone (410) 641-1100

9730 Healthway Dr
Berlin, MD 21811
Phone (410) 629-0164

1003 W 7th St
Ste 200
Frederick, MD 21701
Phone (240) 651-6824

1600 Crain Hwy S
Ste 608
Glen Burnie, MD 21061
Phone (443) 354-1200

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

821 Eastern Shore Dr
Salisbury, MD 21804
Phone (410) 334-6687

6508 Deer Pointe Dr
Ste 4C
Salisbury, MD 21804
Phone (410) 742-6016

6040 Public Landing Rd
Snow Hill, MD 21863
Phone (410) 629-0041

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1104454701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35334 TINGLE RD",
            "city": "WILLARDS",
            "state": "MD",
            "postal_code": "218741323",
            "telephone_number": "443-235-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-543-7162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "WHITNEY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R209524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.