Active NPI
Benjamin Leldon Bradshaw, DC
- Chiropractor
- Sumter, SC
National Provider Identifier
1154553543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3495
- Practice address
- 7 Professional CT
Sumter, SC 29150-1927 - Phone
- (864) 327-7608
- NPI assigned
- Aug 18, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3495 | SC | Primary |
Addresses
Primary practice location
7 Professional CT
Sumter, SC 29150-1927
Mailing address
7 Professional CT
Sumter, SC 29150-1927
Phone (803) 469-0340
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3495 | SC | MD | Occupational Therapist |
Organizations & group practices 1
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.
-
- Chiropractor
- Sumter, SC
- NPI 1487886826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577664000000",
"number": "1154553543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 PROFESSIONAL CT",
"city": "SUMTER",
"state": "SC",
"postal_code": "291501927",
"telephone_number": "803-469-0340",
"fax_number": "803-469-0350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 PROFESSIONAL CT",
"city": "SUMTER",
"state": "SC",
"postal_code": "291501927",
"telephone_number": "864-327-7608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW",
"first_name": "BENJAMIN",
"middle_name": "LELDON",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-18",
"last_updated": "2019-12-30",
"certification_date": "2019-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "SC",
"license": "3495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sumter, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.