NPIMap

Individual provider Active NPI

James Cary Bradshaw, DO

  • Family Medicine Physician
  • Decatur, MS
National Provider Identifier
1982004859
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25173 Issued in MS
Practice address
14884 Highway 15
Decatur, MS 39327
Phone
(604) 635-2258
NPI assigned
Aug 28, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-3202 AR
Family Medicine Physician 207Q00000X 31567 GA
Family Medicine Physician 207Q00000X 25173 MS Primary

Addresses

Primary practice location

14884 Highway 15
Decatur, MS 39327

Mailing address

PO Box 2106
Meridian, MS 39302-2106
Phone (601) 703-4282

Other practice location 1

2514 67th Avenue Loop Ste 112
Meridian, MS 39307-7260
Phone (601) 482-4955

Other practice location 2

607 Sark Dr
Warner Robins, GA 31088-1211
Phone (478) 235-7401

Other practice location 3

2514 67th Avenue Loop Ste 112
Meridian, MS 39307-7260
Phone (601) 482-4955

Other identifiers 1

IdentifierTypeStateIssuer
09131382MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171011003228 MS Practitioner - Family Practice 7012808660 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City Homeopathic Medical College, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laird Hospital, Inc.Group PAC ID 7214991769, shared by 9 NPIs, 30 clinicians

Practice addresses (Care Compare)

14884 Hwy 15
Decatur, MS 39327-9697
Phone (601) 635-2258

24345 Hwy 15
Union, MS 39365-8575
Phone (601) 774-8211

25117 Hwy 15
Union, MS 39365-9088
Phone (601) 774-8214

9097 Collinsville Rd
Collinsville, MS 39325-9779
Phone (601) 626-8874

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.17 of 100Reported as group
Quality
86.99
Improvement activities
40
Cost
66.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
E-3202ARMDFamily Medicine Physician
31567GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laird Hospital, Inc Family Medicine CurrentSince May 1, 2019 Accepting new patients
Rush Medical Foundation Family Medicine CurrentSince Mar 1, 2019 Accepting new patients
Laird Hospital, Inc. CurrentSince May 1, 2019 Accepting new patients
Rush Medical Foundation Family Medicine Current Accepting new patients
Laird Hospital, Inc. Current Accepting new patients
Rush Medical Foundation CurrentSince Mar 1, 2019 Accepting new patients

Locations

9097 Collinsville Rd
Collinsville, MS 39325
Phone (601) 626-8874

14884 Highway 15
Decatur, MS 39327
Phone (601) 635-2258

603 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-2123

25117 Highway 15
Union, MS 39365
Phone (601) 774-8214

Organizations & group practices 6

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1982004859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2106",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393022106",
            "telephone_number": "601-703-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14884 HIGHWAY 15",
            "city": "DECATUR",
            "state": "MS",
            "postal_code": "39327",
            "telephone_number": "604-635-2258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2514 67th Avenue Loop Ste 112",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393077260",
            "country_code": "US",
            "telephone_number": "601-482-4955",
            "fax_number": "601-482-4957",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "607 Sark Dr",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310881211",
            "country_code": "US",
            "telephone_number": "478-235-7401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2514 67th Avenue Loop Ste 112",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393077260",
            "country_code": "US",
            "telephone_number": "601-482-4955",
            "fax_number": "601-482-4957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "JAMES",
        "middle_name": "CARY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-3202",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "31567",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "25173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09131382",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, MS

Sources for this page

Verify at the official NPI Registry.