CAROL BRADSHAW (NPI# 1104277102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104277102 |
| Entity Type | Individual |
| Full Name | CAROL BRADSHAW |
| Credential | RDN, LD |
| Practice Address |
602 Indiana Ave Lubbock TX 79415-3364 |
| Practice Telephone | 8067759363 |
| Mailing Telephone | 8067759363 |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2016-06-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | DT84291 | TX | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326437344 | Carol Bradshaw | Social Worker | 2789 Ortiz Ave, Fort Myers, FL 33905-7806 | 2015-01-14 |
| 1558544007 | Carol Lavern Bradshaw | Dentist | 19005 Wileys Well Rd, Blythe, CA 92225-2287 | 2007-12-06 |
| Street Address |
602 INDIANA AVE |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79415-3364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487659876 | Mark Brendan Reedy | Obstetrics & Gynecology | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2005-06-14 |
| 1417571613 | Chelsea Brooke Seaton | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-06-03 |
| 1437773728 | John Clinton Fisher IIi | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-06-02 |
| 1700409448 | Ryan Everett Hirata | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-05-28 |
| 1013530716 | Lillian Amezquita | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-05-28 |
| 1457990186 | Madison Dreu Williams | Registered Nurse | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-12-28 |
| 1972145977 | Alicia Garcia Castanon | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-10-10 |
| 1770133746 | Candace Kernell | Registered Nurse | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-09-12 |
| 1154883767 | James William Woodwick Jr. | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-04-02 |
| 1811455066 | Rolando Adolfo Lugo II | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831569540 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3502 9th St Ste 280, Lubbock, TX 79415 | 2015-10-07 |
| 1922447457 | Fnu Parijat Kumar | Physical Therapist | 2717 3rd Street, Aptt 803, Lubbock, TX 79415 | 2013-06-18 |
| 1851575906 | Diego Rivera, M.d., P.a. | Family Medicine | 111 University Ave, Lubbock, TX 79415 | 2007-12-26 |
| 1730206632 | Kathleen Brinkman Felts | Physical Therapist | 3710 4th Street, Lubbock, TX 79415 | 2007-03-23 |
| 1568508521 | Horace Rueben Sharp Jr. | Optometrist | 1911 4th St, Lubbock, TX 79415 | 2007-01-29 |
| 1699876201 | Patricia R. Arledge | Plastic Surgery | 3502 9th St., Suite 270, Lubbock, TX 79415 | 2006-09-26 |
| 1245330018 | Perlita Molina Sambrano-tandoc | Nurse Practitioner | 602 East Indiana Avenue, Lubbock, TX 79415 | 2006-09-22 |
| 1639199862 | Justin Tidwell | Emergency Medicine | 604 Indiana, Lubbock, TX 79415 | 2006-07-20 |
| 1912944059 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3301 Clovis Road, Lubbock, TX 79415 | 2006-05-31 |
| 1497709265 | Byron Wayne Schoettle | Radiology | 602 Indiana Avenue, Lubbock, TX 79415 | 2006-05-19 |
| Find all providers in zip 79415 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265078372 | Kaitlin Pharis Smith | Dietitian, Registered | 3004 50th St Ste A, Lubbock, TX 79413-4129 | 2019-11-24 |
| 1467095513 | Sophia Maria Martinez | Dietitian, Registered | 6104 Avenue Q, Lubbock, TX 79412-3506 | 2019-10-22 |
| 1205331998 | Lauren Blechle | Dietitian, Registered | 3615 19th St Bldg 17, Lubbock, TX 79410-1203 | 2018-03-26 |
| 1003357518 | Emmy Lu Henley | Dietitian, Registered | 6520 University Ave, Suite 5, Lubbock, TX 79413 | 2017-03-16 |
| 1730635129 | Katy Rebecca-franklin Poff | Dietitian, Registered | 7008 Indiana Avenue, Suite A, Lubbock, TX 79413 | 2016-08-26 |
| 1639531254 | Lori Ann Boyd | Dietitian, Registered | 2412 50 Th Street, Lubbock, TX 79412 | 2016-03-23 |
| 1972918126 | Premier Nutrition Consulting, LLC | Dietitian, Registered | 2907 Bates St, Lubbock, TX 79415-2646 | 2014-06-26 |
| 1790199248 | Tiffany Ann Quevedo | Dietitian, Registered | 3008 55th St, Lubbock, TX 79413-4802 | 2014-06-12 |
| 1326486549 | Amy Ashmore | Dietitian, Registered | 602 Indiana Ave # 5980, Lubbock, TX 79415-3364 | 2013-06-10 |
| 1952672578 | Brooksgate Inc. | Dietitian, Registered | 6829 6th St, Lubbock, TX 79416-3769 | 2012-01-13 |
| Find all providers in LUBBOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.