Carol Bradshaw

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5046 Issued in FL

Practice address

2789 Ortiz Ave
Fort Myers, FL 33905-7806

Phone

(239) 275-4242

NPI assigned

Jan 14, 2015

Sex

Female

Sole proprietor

Yes

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)

Enrolled

State licenses

Practice roles

Locations

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

• Ultima Rehab-FL LLC

  • Geriatric Physical Therapist
  • North Fort Myers, FL
  • NPI 1053970194
  NPD

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1326437344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3763 EVANS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019302",
            "telephone_number": "239-275-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2789 ORTIZ AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057806",
            "telephone_number": "239-275-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "CAROL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-14",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "5046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Bradley, ARNP
• Erin Bradley, DOT
• Jimmie Braxton Bradley, D.C.
• Nina Grace Bradley, D.O.
• Scott Allan Bradley Jr., PT, DPT
• Jeremi Tricia Braga, NNP-BC
• Mark Braganza
• Nancy Bragaw Patten
• Maureen Brague
• Angel Braham, LPN

• Clinical Social Worker in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; 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.