Susan Bradshaw, APRN FNP
Individual provider Active NPI Family Nurse Practitioner · Russell Springs, KY
NPI 1366893299 · NPPES record last updated Feb 28, 2024
Key facts
- NPI
- 1366893299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 3010143 (KY)
- Practice address
- 124 Dowell Road
Russell Springs, KY 42642 - Phone
- (270) 866-2440
- Fax
- (270) 866-2442
- NPI assigned
- Jun 22, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Russell County Hospital
Practice addresses (Care Compare)
124 Dowell Rd
Russell Springs, KY 42642-4235
153 Dowell Rd
Russell Springs, KY 42642-4579
Phone (270) 866-4141
169 Joe T Petty Dr
Russell Springs, KY 42642-8533
Phone (270) 865-1002
PO Box
Suite 1610
Russell Springs, KY 42642
Hospital & facility affiliations
- Russell County Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160919002599 | KY | Practitioner - Nurse Practitioner | 9133416142 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Russell County Hospital | Current |
Accepting new patients | |
| Russell County Hospital | Current |
Accepting new patients | |
| Russell County Hospital | Current | Accepting new patients | |
| Eastern Pulaski Rural Health Clinic,PLLC | Past | Accepting new patients |
Locations
124 Dowell Rd
Russell Springs, KY 42642
Phone (270) 866-2440
169 Joe T Petty Dr
Russell Springs, KY 42642
Phone (270) 865-1002
153 Dowell Rd
Russell Springs, KY 42642
Phone (270) 866-4141
31 Mark Shopville Rd
Somerset, KY 42503
Phone (606) 485-4553
Interoperability endpoints
- susan.bradshaw@crch.eclinicaldirectplus.com
- sbradshaw@fmc1.gwaydirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3010143 | KY | Yes |
Addresses
Primary practice location
124 Dowell Road
Russell Springs, KY 42642
Mailing address
124 Dowell Road
Russell Springs, KY 42642
Phone (270) 866-2440
Other providers in Russell Springs, KY
- Rhonda Dawn Begley
- Robert L. Bertram
- Barrett K Blakey
- Jana K Bowmer
- Macon Samuel Bradley
- Ashley Bragg
- James Baxter Brown
- Shannon Lee Brown
- Angelia Shaw Bryant
- Heather Craft Bull
All providers in Russell Springs, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.