Thomas Bradshaw

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

30174 Issued in MD

Practice address

18714 N Village
Hagerstown, MD 21742-2454

Phone

(301) 733-0331

NPI assigned

Jun 19, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brook Lane Behavioral Services, Inc.Group PAC ID 5991055022, 23 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.

• Brook Lane Behavioral Services, Inc.

  • Psychiatry Physician
  • Hagerstown, MD
  • NPI 1538647748

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1952086977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18714 N VILLAGE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217422454",
            "telephone_number": "301-733-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18714 N VILLAGE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217422454",
            "telephone_number": "301-733-0331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5407 N Charles St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212102024",
            "country_code": "US",
            "telephone_number": "410-433-8861 x231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "703 W Patrick St",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217014029",
            "country_code": "US",
            "telephone_number": "410-433-8861 x231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "30174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kasi Boyer, PHARMD
• Patricia L Boyst, CRNP
• Matthew Bracken, PA-C
• James Hamilton Bradford, CCDC, CAC A/D
• Carolyn Bradley
• Nicholas John Branca, PA-C
• Branch Home Care LLC
• Jamie Branch
• Christopher Allen Brandon, PA
• Justin P Brandt, DO

• Clinical Social Worker in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.