Individual provider Active NPI

Kim Bradshaw, M.D.

  • Internal Medicine Physician
  • Hiram, GA
National Provider Identifier
1255786471
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
83443 Issued in GA
Practice address
2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068
Phone
(404) 644-8027
NPI assigned
Apr 25, 2016
Last updated
Apr 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 83443 GA Primary

Addresses

Primary practice location

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068

Mailing address

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068
Phone (404) 644-8027

Other practice location 1

720 Westview Dr SW
Atlanta, GA 30310-1458
Phone (404) 756-1368

Other identifiers 1

IdentifierTypeStateIssuer
390200000MedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbradshaw614726@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190918003724 GA Practitioner - HospitalistPractitioner - Internal Medicine 0547590440 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Howard University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068
Phone (770) 732-4022

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4022

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

601 S 8TH St
Griffin, GA 30224-4213
Phone (770) 228-2721

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (678) 838-2585

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.29 of 100Reported as group
Quality
70.79
Improvement activities
40
Cost
81.32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Mar 1, 2025 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Apogee Medical Group Georgia Inc Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients
South Georgia Medical Center Inc Student in an Organized Health Care Education/Training Program Past Accepting new patients
Paulding Medical Center, Inc. Past Accepting new patients

Locations

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (470) 644-7000

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

116 W Thigpen Ave
Lakeland, GA 31635
Phone (229) 482-8440

1221 E McPherson Ave
Nashville, GA 31639
Phone (229) 543-7100

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1255786471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 JIMMY LEE SMITH PKWY",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412068",
            "telephone_number": "404-644-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2518 JIMMY LEE SMITH PKWY",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412068",
            "telephone_number": "404-644-8027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Westview Dr SW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303101458",
            "country_code": "US",
            "telephone_number": "404-756-1368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "KIM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-25",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "83443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390200000",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbradshaw614726@directwellstar.org",
            "affiliation": "N",
            "address_1": "2518 Jimmy Lee Smith Pkwy",
            "city": "Hiram",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301412068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

Verify at the official NPI Registry.