Individual provider Active NPI

Misti Dawn Bryant Bradshaw, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Longview, TX
National Provider Identifier
1306595020
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1044452 Issued in TX
Practice address
425 N Fredonia St
Longview, TX 75601-6464
Phone
(903) 758-2610
Fax
(903) 758-7081
NPI assigned
Mar 21, 2022
Last updated
Aug 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1044452 TX Primary

Addresses

Primary practice location

425 N Fredonia St
Longview, TX 75601-6464

Mailing address

1107 E Marshall Ave
Longview, TX 75601-5602
Phone (903) 758-2610

Other practice location 1

921 14th Ave
Longview, WA 98632-2316
Phone (360) 423-0203

Other practice location 2

1107 E Marshall Ave
Longview, TX 75601-5602
Phone (903) 758-2610

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address misti.bradshaw@christushealth.org Direct
Direct Messaging Address misti.bradshaw@wellnesspointe.ort Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230220000037 TX Practitioner - Nurse Practitioner 4880066950 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Management AssociatesGroup PAC ID 7810299187, 35 clinicians

Practice addresses (Care Compare)

4006 Vista Rd
Pasadena, TX 77504-2112
Phone (888) 365-6271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1044452TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Good Shepherd Medical Center CurrentSince Jan 19, 2023 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jul 12, 2024 Accepting new patients
Longview Wellness Center Inc CurrentSince Apr 21, 2025 Accepting new patients
Opgt Inc CurrentSince Dec 1, 2022 Accepting new patients
Med Management Associates CurrentSince May 19, 2025 Accepting new patients
Christus Good Shepherd Medical Center CurrentSince Jan 19, 2023 Accepting new patients
Longview Wellness Center Inc CurrentSince Apr 21, 2025 Accepting new patients
Longview Wellness Center, Inc Current Accepting new patients
Longview Wellness Center Inc PastSince Jan 2, 2022 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

1107 E Marshall Ave
Longview, TX 75601
Phone (903) 212-4763

1701 Pine Tree Rd
Longview, TX 75604
Phone (713) 292-3177

425 N Fredonia St
Longview, TX 75601
Phone (903) 234-1452

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

811 S Washington Ave
Marshall, TX 75670
Phone (903) 315-1488

3300 S FM 1788
Midland, TX 79706
Phone (432) 561-5915

4006 Vista Rd
Pasadena, TX 77504
Phone (713) 943-1592

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

Interoperability endpoints

  • Direct secure messaging: misti.bradshaw@christushealth.org
  • Direct secure messaging: misti.bradshaw@wellnesspointe.ort

Organizations & group practices 9

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": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1306595020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015602",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N FREDONIA ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756016464",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 14th Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986322316",
            "country_code": "US",
            "telephone_number": "360-423-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1107 E Marshall Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015602",
            "country_code": "US",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT BRADSHAW",
        "first_name": "MISTI",
        "middle_name": "DAWN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1044452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "misti.bradshaw@christushealth.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "327 Hillshore Dr",
            "city": "Longview",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756057060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "misti.bradshaw@wellnesspointe.ort",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1107 E Marshall Ave",
            "city": "Longview",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756015602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.