Shamika J Bradshaw

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

66697 Issued in TX

Practice address

2200 Ross Ave
Waco, TX 76706-2744

Phone

(254) 224-1586

NPI assigned

Apr 21, 2022

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1396489902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4332 BLACKWELL ST",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767052213",
            "telephone_number": "254-715-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 ROSS AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767062744",
            "telephone_number": "254-224-1586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1612 Columbus Ave",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767011125",
            "country_code": "US",
            "telephone_number": "254-224-1586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "SHAMIKA",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "66697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makayla J Bradford, AUD
• Marion Dielle Bradford, OTR
• Calvin Bradley, MD
• Jamie Elaine Bradley
• Ronald W Bradshaw, MD
• Cody Landon Brady, LCDC 17747
• Norbert R. Braeuer, M.D.
• Heather Renee Branch, FNP
• Tara Louise Brandon
• Linda Ellen Branz, N.P.

• Clinical Social Worker in Waco, TX
• Providers in Waco, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.