MRS. KACY LEE BRADSHAW NNP
NPI 1972816593
Nurse Practitioner - Neonatal, Critical Care in Salem, OR
About Mrs. Kacy Lee Bradshaw Nnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KACY LEE BRADSHAW NNP (NPI 1972816593) is an individual neonatal, critical care provider in Salem, Oregon, licensed in Oregon (201050101NP) and active in the NPI registry since July 2010. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Kacy Lee Bradshaw Nnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kacy Bradshaw reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Salem, OR 97317
- Reassigned Medicare billing, Oregon and Washington enrollments
- Medicare enrollment name: Kaiser Foundation Health Plan Of The Northwest
- Also billed through NPI 1871848457 (Washington)
- 3,207 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SALEM, OR 97301
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 Kacy Bradshaw's NPI number?
The NPI number for Kacy Bradshaw is 1972816593. It was assigned to this individual provider in the NPPES registry on July 24, 2010.
Where is Kacy Bradshaw located?
Kacy Bradshaw practices at 939 Oak St SE, Salem, OR 97301. The listed phone number is (503) 814-3561.
What is Kacy Bradshaw's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Neonatal, Critical Care, with taxonomy code 363LN0005X.
Is Kacy Bradshaw enrolled in Medicare?
Yes. Kacy Bradshaw is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kacy Bradshaw's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kacy Bradshaw reassigns Medicare benefits to South Salem Rehabilitation, LLC (Salem, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kacy Bradshaw's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kacy Bradshaw was last updated on July 24, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Mrs. Kacy Lee Bradshaw, NNP · NPI 1972816593
Neonatal, Critical Care physician in Salem, Oregon. Individual provider, active in the CMS NPPES registry since July 24, 2010.
## Identity
- **NPI:** 1972816593 (Entity type: Individual)
- **Enumerated:** July 24, 2010
- **Primary specialty:** Nurse Practitioner - Neonatal, Critical Care · taxonomy 363LN0005X
- **State license:** 201050101NP (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 939 OAK ST SE, Salem, OR 97301-3901
- **Phone:** (503) 814-3561 · **Fax:** (503) 814-3560
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** South Salem Rehabilitation, LLC (NPI 1215071998, Salem, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 24, 2010
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Source: [NPI Profile](https://npiprofile.com/npi/1972816593) · Data from the CMS NPPES public registry.