Active NPI
Ramon Scott Bradshaw, PA-C
- Physician Assistant
- Savannah, GA
National Provider Identifier
1154435592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10677
- Practice address
- 4750 Waters Ave.
Suite 112
Savannah, GA 31404 - Phone
- (912) 355-1070
- Fax
- (912) 355-9773
- NPI assigned
- Aug 19, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601002965 | MI | |
| Physician Assistant | 363A00000X | 10677 | GA | Primary |
Addresses
Primary practice location
4750 Waters Ave.
Suite 112
Savannah, GA 31404
Mailing address
4750 Waters Ave.
Suite 112
Savannah, GA 31404
Phone (912) 355-1070
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220128001515 | VA | Practitioner - Physician Assistant | 4183050297 | Reassigns benefits to 1 organization |
| I20230919001206 | GA | Practitioner - Physician Assistant | 4183050297 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8000
4750 Waters Ave
Suite 112
Savannah, GA 31404-6267
Phone (912) 355-1070
Hospital & facility affiliations
- Savannah Health Services LLC Dba Memorial Health University Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10677 | GA | MD | Pharmacotherapy Pharmacist |
| 5601002965 | MI | MD | Physician Assistant |
Organizations & group practices 2
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.
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692662400000",
"number": "1154435592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4750 WATERS AVE.",
"address_2": "SUITE 112",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "31404",
"telephone_number": "912-355-1070",
"fax_number": "912-355-9773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4750 WATERS AVE.",
"address_2": "SUITE 112",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "31404",
"telephone_number": "912-355-1070",
"fax_number": "912-355-9773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW",
"first_name": "RAMON",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2023-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601002965",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "10677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Savannah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.