MR. JOHNNIE MACK BRADSHAW PA-C
NPI 1740386267
Physician Assistant in Charlotte, NC

Q: What is Johnnie Bradshaw's NPI number?

The NPI number for Johnnie Bradshaw is 1740386267. It was assigned to this individual provider in the NPPES registry on September 15, 2006.

Q: What is Johnnie Bradshaw's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Johnnie Bradshaw was last updated on February 28, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since September 15, 2006

2001 RANDOLPH RD, CHARLOTTE, NC 28207(704) 323-2000 Get Directions Write a Review

NPPES record last updated: February 28, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Johnnie Mack Bradshaw Pa-c NPPES

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

MR. JOHNNIE MACK BRADSHAW PA-C (NPI 1740386267) is an individual physician assistant in Charlotte, North Carolina, licensed in North Carolina (100701) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1740386267

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. JOHNNIE MACK BRADSHAWCredential: PA-C

Location Address2001 RANDOLPH RDCharlotte, NC 28207-1215

Mailing Address4601 Park Rd, Suite 300Charlotte, NC 28209-3239 · (704) 323-2000

Phone(704) 323-2000

Sole ProprietorNo

Enumeration DateSeptember 15, 2006

Last NPPES UpdateFebruary 28, 2014

✔ NPI 1740386267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NC · 100701

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

2001 RANDOLPH RD, Charlotte, NC 28207

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Other Identifiers 1

Other100701NC · Nc Medical License

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.

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