Peter S. Bradshaw M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PETER S. BRADSHAW M.D.

Practice address

77 E Merrimack St
Suite 15
Lowell, MA 01852-1251

Phone

(978) 459-3341

Fax

(978) 459-5344

NPI assigned

Sep 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Peter Shewell Bradshaw, M.D.

Title

Owner

Phone

(978) 459-3341

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1154515013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 E MERRIMACK ST",
            "address_2": "SUITE 15",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521251",
            "telephone_number": "978-459-3341",
            "fax_number": "978-459-5344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 E MERRIMACK ST",
            "address_2": "SUITE 15",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521251",
            "telephone_number": "978-459-3341",
            "fax_number": "978-459-5344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER S. BRADSHAW M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "BRADSHAW",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "SHEWELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-459-3341",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2055074",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "M17561",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jonathan A. Peters
• Marnie Peters, OTR
• Paula C Peters, BCBA/LABA
• Valerie Ann Peterson, MA
• Tessa Petri

• Internal Medicine Physician in Lowell, MA
• Providers in Lowell, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.