Bradshaw Health, PLLC
Organization Active NPI Adult Health Nurse Practitioner · Lebanon, TN
NPI 1699214437 · NPPES record last updated Mar 19, 2024
Key facts
- NPI
- 1699214437
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 5732 (TN)
- Legal business name
- BRADSHAW HEALTH, PLLC
- Practice address
- 1420 W Baddour Pkwy Ste 240
Lebanon, TN 37087-1510 - Phone
- (615) 444-4126
- Fax
- (855) 785-2890
- NPI assigned
- Feb 13, 2017
- Organization subpart
- No
Authorized official
- Name
- Brenda M McFarlin, APRN-BC
- Title
- Owner
- Phone
- (615) 444-4126
Practitioners 7
-
Brenda Manning McFarlin, APRN
-
Kristin Nicole Hill, MSN, FNP-C
-
Regina Puryear, NURSE PRACTITIONER
-
Justin Groce, APRN
-
Connesuala Walden, APRN
-
Brandon Saunders, FNP-BC
-
Ali N Sorrell, FNP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0307243 | Bradshaw Health, PLLC | Certificate of waiver | Jan 31, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170601001410 | TN | Part B Supplier - Clinic/Group Practice | 4880961416 |
Receives reassigned benefits from 4 practitioners Practice locations: Lebanon, TN |
National Provider Directory
Locations
115 Winwood Dr
Ste 105
Lebanon, TN 37087
Phone (615) 444-4126
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | 818 | TN | |
| Physician Assistant |
363A00000X | 627 | TN | |
| Adult Health Nurse Practitioner |
363LA2200X | 5732 | TN | Yes |
| Adult Health Nurse Practitioner |
363LA2200X | 20598 | TN | |
| Primary Care Nurse Practitioner |
363LP2300X |
Addresses
Primary practice location
1420 W Baddour Pkwy Ste 240
Lebanon, TN 37087-1510
Mailing address
1420 W Baddour Pkwy Ste 240
Lebanon, TN 37087-1510
Phone (615) 444-4126
Other providers in Lebanon, TN
- Tyler Bott
- Botts Diabetes & Endocrinology
- Dara W Botts
- John R Boucher
- F Kirk Bowles
- Bradshaw Medical Clinic, PC
- Regina Falei Bragg
- John Bratcher
- Bridgeway Mental Health Center
- Krista Bright
All providers in Lebanon, TN · Adult Health Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 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.
- 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.