Tyler John Bradshaw, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

8338 Issued in AZ

Practice address

21321 E Ocotillo Rd Ste 125
Queen Creek, AZ 85142-5995

Phone

(480) 677-4800

Fax

(480) 677-4806

NPI assigned

Jul 11, 2013

Sex

Male

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

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Epic Healthcare and Physical MedicineGroup PAC ID 5890931422, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Epic Healthcare and Physical Medicine

  • General Practice Physician
  • Flower Mound, TX
  • NPI 1518205483
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1588005136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD STE 125",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD STE 125",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425995",
            "telephone_number": "480-677-4800",
            "fax_number": "480-677-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "TYLER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-11",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Bowes
• Robert Charles Bowman, M.D.
• Jena Patrice Boynton, WHNP-BC
• Carol S Bradford, NP-C
• Riannon Bradshaw, CD
• Chris M Braegger, PHARMD
• Nichole Brainard, RN BSN
• Shaun Brancheau, DO
• Luis Javier Bravo Pagan, MD
• Brighter Days Mental Health and Wellness

• Chiropractor in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.