Coree Bradshaw

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

220113 Issued in OK

Practice address

6100 S Walker Ave
Oklahoma City, OK 73139-7026

Phone

(405) 634-4400

NPI assigned

Jan 24, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hope Community Services, Inc.

  • Community/Behavioral Health Agency
  • Oklahoma City, OK
  • NPI 1386775039
  NPD (past)
• Star View Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Sylmar, CA
  • NPI 1205580206
  NPD (past)
• Star View Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Downey, CA
  • NPI 1710633326
  NPD (past)

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1730941972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 S WALKER AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731397026",
            "telephone_number": "405-634-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 S WALKER AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731397026",
            "telephone_number": "405-634-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "COREE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "220113",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skylar Bradley
• Taryn Lenore Bradley
• Vanessa Bradley, LADC-MH
• Alecia Bradshaw
• Chris D Bradshaw, D.O.
• David Lamar Bradshaw, D.O.
• Hananh Bradshaw
• Hunter Ryan Bradshaw
• Monica C Bradshaw
• Teresa A Bradshaw, CRNFA

• Licensed Practical Nurse in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Licensed Practical Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.