Charli Bradshaw

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA101919 Issued in MA

Practice address

419B Andover St
North Andover, MA 01845-5001

Phone

(978) 620-5048

Fax

(978) 620-5073

NPI assigned

Nov 17, 2023

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

Enrolled in MA, NH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Convenientmd - FFS UC LLCGroup PAC ID 5193186492, shared by 3 NPIs, 397 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Worcester, MA
  • NPI 1790528628
  Medicare reassignment
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Nashua, NH
  • NPI 1851082291
  Medicare reassignment
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Sturbridge, MA
  • NPI 1386526192
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Manchester, NH
  • NPI 1952092397
  NPD

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

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1821863069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419B ANDOVER ST",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455001",
            "telephone_number": "978-620-5048",
            "fax_number": "978-620-5073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "49 Plaistow Rd",
            "address_purpose": "LOCATION",
            "city": "Plaistow",
            "state": "NH",
            "postal_code": "038652854",
            "country_code": "US",
            "telephone_number": "603-371-3229",
            "fax_number": "603-371-3239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "CHARLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-17",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA101919",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "3534",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Lynn Boucher, M.S.
• William L Bourassa, D.M.D.
• Lawrence Bourdeau, DPT, ATC, CSCS, OTC
• Gillian Bowdidge, MS CCC-SLP
• Winifred Bowersox
• Alexis Bel Brandon
• Nicole Brennan, DPT
• Carli Brent, SLP
• Brian H Yoon, DMD LLC
• Kathleen Brien

• Physician Assistant in North Andover, MA
• Providers in North Andover, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.