Kevin C. Bradshaw, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

PO526 Issued in DC

Practice address

519 Peabody St NE
Washington, DC 20011-1647

Phone

(202) 285-1465

Fax

(202) 635-2305

NPI assigned

Dec 11, 2006

Last updated

Nov 10, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226275200000",
    "number": "1972663888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 PEABODY ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200111647",
            "telephone_number": "202-285-1465",
            "fax_number": "202-635-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 PEABODY ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200111647",
            "telephone_number": "202-285-1465",
            "fax_number": "202-635-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "KEVIN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2008-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "DC",
            "license": "PO526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0115995 00",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE/RAILROAD PIN",
            "identifier": "48002901",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarita Bradley, HHA
• Tamara Bradley
• Andrew Bradshaw, LGSW
• Danielle Bradshaw
• Eric Michael Bradshaw Sr., D.D.S.
• Monica Bradshaw
• Myles Bradshaw
• Serena Bradshaw
• Sharai Bradshaw, LMFT
• Sharday Bradshaw

• Podiatrist in Washington, DC
• Providers in Washington, DC by specialty
• Podiatrist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.