Bradley Rex Shumway, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

006808 Issued in AZ

Practice address

4447 E Broadway Rd Ste 107
Mesa, AZ 85206-2018

Phone

(480) 550-9610

Fax

(480) 500-6856

NPI assigned

Jun 2, 2014

Last updated

Jan 14, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 30, 2020 through Oct 30, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1346652864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4447 E BROADWAY RD STE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062018",
            "telephone_number": "480-550-9610",
            "fax_number": "480-500-6856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4447 E BROADWAY RD STE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062018",
            "telephone_number": "480-550-9610",
            "fax_number": "480-500-6856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7301 E 2nd St",
            "address_2": "Ste. 210",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852515600",
            "country_code": "US",
            "telephone_number": "480-882-4545",
            "fax_number": "480-946-6697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUMWAY",
        "first_name": "BRADLEY",
        "middle_name": "REX",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-02",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "006808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Louise Shuey, CNP
• Sarah Shuker, PA-C
• Shukung PLLC
• John David Shull Jr., PA
• Lawrence Shults, D.D.S. MSD
• David Dean William Shumway, M.ED.
• Joel Andrew Shumway, DDS
• Bailey Lynn Shupe, RD
• Lynae Shurtz, RN
• Jeffrey Lee Shy, MD

• Family Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.