Active NPI
Katherine F Bradshaw-Smith, PHYSICIAN ASST CERT
- Medical Physician Assistant
- Poway, CA
National Provider Identifier
1235214602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA11292
- Practice address
- 15721 Pomerado Road
Poway, CA 92064 - Phone
- (858) 673-0653
- Fax
- (858) 485-0371
- NPI assigned
- Oct 26, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA11292 | CA | Primary |
Addresses
Primary practice location
15721 Pomerado Road
Poway, CA 92064
Mailing address
15721 Pomerado Road
Poway, CA 92064
Phone (858) 673-0653
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11292 | CA | MD | Orthopedic Chiropractor |
| PA11292 | CA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279670400000",
"number": "1235214602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15721 POMERADO ROAD",
"city": "POWAY",
"state": "CA",
"postal_code": "92064",
"telephone_number": "858-673-0653",
"fax_number": "858-485-0371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15721 POMERADO ROAD",
"city": "POWAY",
"state": "CA",
"postal_code": "92064",
"telephone_number": "858-673-0653",
"fax_number": "858-485-0371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW-SMITH",
"first_name": "KATHERINE",
"middle_name": "F",
"name_prefix": "Mrs.",
"credential": "PHYSICIAN ASST CERT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2010-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA11292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poway, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.