Individual provider Active NPI

Ramon Scott Bradshaw, PA-C

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1154435592
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10677 Issued in GA
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

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
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
Georgia Nasal and Sinus Institute PCGroup PAC ID 3274438320, 2 clinicians

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 Hospital, Savannah, GA, CCN 110036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10677GAMDPharmacotherapy Pharmacist
5601002965MIMDPhysician 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

Verify at the official NPI Registry.