Active NPI
Melonie Bradshaw, PEER SUPPORT
- Peer Specialist
- Saint George, UT
National Provider Identifier
1114499258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 1035
- Practice address
- 1085 S Bluff St
Saint George, UT 84770-5245 - Phone
- (801) 465-5111
- NPI assigned
- Dec 31, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 1035 | UT | Primary |
Addresses
Primary practice location
1085 S Bluff St
Saint George, UT 84770-5245
Mailing address
1085 S Bluff St
Saint George, UT 84770-5245
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 |
|---|---|---|---|
| 1035 | UT | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546214400000",
"number": "1114499258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1085 S BLUFF ST",
"city": "SAINT GEORGE",
"state": "UT",
"postal_code": "847705245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1085 S BLUFF ST",
"city": "SAINT GEORGE",
"state": "UT",
"postal_code": "847705245",
"telephone_number": "801-465-5111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW",
"first_name": "MELONIE",
"credential": "PEER SUPPORT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-31",
"last_updated": "2018-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "UT",
"license": "1035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.