Nicole Renee Bradshaw, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

02256 Issued in OH

Practice address

717 Neil Ave
Columbus, OH 43215-1609

Phone

(614) 228-8888

NPI assigned

Jan 9, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1174096416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 SHERIDAN ST",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012556",
            "telephone_number": "740-503-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 NEIL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151609",
            "telephone_number": "614-228-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-09",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "02256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rochelle L Bradley, LMT
• Shantrice Bradley
• Teresa Bradley
• Tessy Bradley
• Twylia Bradley
• Lauren Bradstreet, PH.D
• Taylor Bradt
• Anne M Brady, LISW-S
• Ashley Christine Brady, M.A. CCC-SLP
• Cara Brady, LSW

• All providers in Columbus, OH
• Occupational Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.