Kelley Bradshaw, M.S., R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1012906 Issued in CA

Practice address

13851 E 14TH St
Suite 102
San Leandro, CA 94578-2631

Phone

(510) 351-2100

NPI assigned

Feb 21, 2012

Last updated

Feb 21, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  NPD
• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  NPD
• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1477826444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 WEST 135TH AVE.",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774115",
            "telephone_number": "510-483-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13851 E 14TH ST",
            "address_2": "SUITE 102",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782631",
            "telephone_number": "510-351-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "KELLEY",
        "credential": "M.S., R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-21",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1012906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Bradford
• Roshawnda Latrice Bradford
• Adrian Bradley
• Kimberly A Bradley, PSYD
• Narkyitta Bradley
• Kathleen Evangeline Brahan
• Devin Branch II
• Karen Brandman, MFT
• Justin Adee Brandon
• Alisha Blau Braun, PTA

• Registered Dietitian in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.