Individual provider Active NPI

Kimberly Aman Bradshaw

  • Speech-Language Pathologist
  • Wilmington, NC
National Provider Identifier
1780056499
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3079 Issued in NC
Practice address
5919 Oleander Dr
Wilmington, NC 28403-4780
Phone
(910) 395-2995
NPI assigned
Oct 21, 2015
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3079 NC Primary

Addresses

Primary practice location

5919 Oleander Dr
Wilmington, NC 28403-4780

Mailing address

5919 Oleander Dr
Wilmington, NC 28403-4780
Phone (910) 395-2995

Other practice location 1

7011 Gum Branch Rd
Richlands, NC 28574-8227
Phone (910) 347-2212

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

State licenses

LicenseStateTypeSpecialty
3079NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech 4 Kidz, Inc Speech-Language Pathologist PastSince Mar 9, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1780056499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5919 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034780",
            "telephone_number": "910-395-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5919 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034780",
            "telephone_number": "910-395-2995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7011 Gum Branch Rd",
            "address_purpose": "LOCATION",
            "city": "Richlands",
            "state": "NC",
            "postal_code": "285748227",
            "country_code": "US",
            "telephone_number": "910-347-2212",
            "fax_number": "910-338-5013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "KIMBERLY",
        "middle_name": "AMAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-21",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "3079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.