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JONATHAN BRADSHAW DO
NPI 1497442966
Student in an Organized Health Care Education/Training Program in Fayetteville, NC

Active since April 24, 2023PECOS Enrolled
1638 OWEN DRIVE, FAYETTEVILLE, NC 28304(910) 615-4000 Get Directions Write a Review

NPPES record last updated: April 24, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jonathan Bradshaw Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONATHAN BRADSHAW DO (NPI 1497442966) is an individual student in an organized health care education/training program in Fayetteville, North Carolina and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1497442966
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJONATHAN BRADSHAWCredential: DO
Location Address1638 OWEN DRIVEFayetteville, NC 28304-3424
Mailing Address1638 Owen DriveFayetteville, NC 28304-3424 · (910) 615-4000
Phone(910) 615-4000
Sole ProprietorYes
Enumeration DateApril 24, 2023
NPPES CertifiedApril 24, 2023
✔ NPI 1497442966 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1638 OWEN DRIVE, Fayetteville, NC 28304
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jonathan Bradshaw Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRENDA A ALCOCER APRN
Nurse Practitioner (Family)
1638 OWEN DRIVE
FAYETTEVILLE, NC 28304
Cumberland County (984) 977-8772
NICOLE EBALO
Student in an Organized Health Care Education/Training Program
1638 OWEN DRIVE
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-4000
KALYAN RAM SAIGANESH
Student in an Organized Health Care Education/Training Program
1638 OWEN DRIVE
FAYETTEVILE, NC 28304
Cumberland County (910) 615-0000
ANTONIOS ANAGNOSTOPOULOS DO
Psychiatry & Neurology (Psychiatry)
1638 OWEN DRIVE
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-5095
MATTHEW WESTON PRIOR DO
Student in an Organized Health Care Education/Training Program
1638 OWEN DRIVE
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-4000
ERIC MICHAEL ACKER MD
Student in an Organized Health Care Education/Training Program
1638 OWEN DRIVE
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-3960
BROOKE MARTIN DO
Student in an Organized Health Care Education/Training Program
1638 OWEN DRIVE
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-4000
REBEKAH BRYTON CARY DO
Student in an Organized Health Care Education/Training Program
1638 OWEN DRIVE
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-3500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Bradshaw's NPI number?

The NPI number for Jonathan Bradshaw is 1497442966. It was assigned to this individual provider in the NPPES registry on April 24, 2023.

Where is Jonathan Bradshaw located?

Jonathan Bradshaw practices at 1638 Owen Drive, Fayetteville, NC 28304. The listed phone number is (910) 615-4000.

What is Jonathan Bradshaw's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jonathan Bradshaw enrolled in Medicare?

Yes. Jonathan Bradshaw is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jonathan Bradshaw was last updated on April 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.