Active NPI
Alex Bradshaw, MS, OTR/L
- Occupational Therapist
- Louisville, KY
National Provider Identifier
1588043673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- R5212
- Practice address
- 1913 Harvard Dr
Louisville, KY 40205-1829 - Phone
- (502) 551-6583
- NPI assigned
- May 22, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | R5212 | KY | Primary |
Addresses
Primary practice location
1913 Harvard Dr
Louisville, KY 40205-1829
Mailing address
1913 Harvard Dr
Louisville, KY 40205-1829
Phone (502) 551-6583
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 71000000320 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R5212 | KY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432252800000",
"number": "1588043673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1913 HARVARD DR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402051829",
"telephone_number": "502-551-6583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1913 HARVARD DR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402051829",
"telephone_number": "502-551-6583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW",
"first_name": "ALEX",
"name_prefix": "Mr.",
"credential": "MS, OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-22",
"last_updated": "2015-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "R5212",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "71000000320",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.