Active NPI
Molly Teeling Bradshaw, RN
- Registered Nurse
- Woodstock, GA
National Provider Identifier
1144805409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN262755
- Practice address
- 105 Mirramont Lake Dr
Woodstock, GA 30189-8214 - Phone
- (770) 485-9670
- NPI assigned
- Mar 17, 2021
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN262755 | GA | Primary |
Addresses
Primary practice location
105 Mirramont Lake Dr
Woodstock, GA 30189-8214
Mailing address
105 Mirramont Lake Dr
Woodstock, GA 30189-8214
Phone (707) 485-9670
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN262755 | GA | MD | Registered Nurse |
Interoperability endpoints
- molly.bradshaw@3781.securemail.prognocis.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676419200000",
"number": "1144805409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 MIRRAMONT LAKE DR",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301898214",
"telephone_number": "707-485-9670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 MIRRAMONT LAKE DR",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301898214",
"telephone_number": "770-485-9670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW",
"first_name": "MOLLY",
"middle_name": "TEELING",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-17",
"last_updated": "2023-02-15",
"certification_date": "2023-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "GA",
"license": "RN262755",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.