Active NPI
Ashley Suzannah Bradshaw, M.S., R.D.,L.D.N
- Registered Dietitian
- Shumway, IL
National Provider Identifier
1265860274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.006035
- Practice address
- 16381 N 850TH St
Shumway, IL 62461-2317 - Phone
- (217) 821-1319
- NPI assigned
- Oct 30, 2013
- Last updated
- Apr 14, 2026
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.006035 | IL | Primary |
Addresses
Primary practice location
16381 N 850TH St
Shumway, IL 62461-2317
Mailing address
16381 N 850TH St
Shumway, IL 62461-2317
Phone (217) 821-1319
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.006035 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Awakened Actions, LLC. | Dietitian, Registered | Current | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776124800000",
"number": "1265860274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16381 N 850TH ST",
"city": "SHUMWAY",
"state": "IL",
"postal_code": "624612317",
"telephone_number": "217-821-1319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16381 N 850TH ST",
"city": "SHUMWAY",
"state": "IL",
"postal_code": "624612317",
"telephone_number": "217-821-1319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW",
"first_name": "ASHLEY",
"middle_name": "SUZANNAH",
"credential": "M.S., R.D.,L.D.N",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-30",
"last_updated": "2026-04-14",
"certification_date": "2026-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.006035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shumway, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.