MICHAEL SHANE BRADLEY (NPI# 1265860878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265860878 |
| Entity Type | Individual |
| Full Name | MICHAEL SHANE BRADLEY |
| Credential | PA-C |
| Practice Address |
404 Shoppers Dr Winchester KY 40391-1378 |
| Practice Telephone | 8597375333 |
| Practice Fax Number | 8597370070 |
| Mailing Telephone | 8597375333 |
| Mailing Fax Number | 8597370070 |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2020-04-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA1825 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100277800 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 370 Amsden Ave Ste 503, Versailles, KY 403836928 | 8597375333 | 8597370070 |
| 8 Linville Dr Ste B, Paris, KY 403612170 | 5025703754 | 5025703756 |
| 1138 Lexington Rd Ste 110, Georgetown, KY 403249673 | 5025703754 | 5025703756 |
| 235 Boggs Ln Ste 7, Richmond, KY 404753325 | 8596259959 | 8596259958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487179396 | Michael Bradley | Driver | 1202 Taylor St, Fredericksburg, VA 22401-2664 | 2017-08-11 |
| 1346438231 | Michael E Bradley | Occupational Therapist | 4179 Woodley Creek Rd, Jacksonville, FL 32218-9185 | 2007-10-04 |
| 1225131444 | Michael James Bradley | Ophthalmology | 11820 S State St, Draper, UT 84020-7133 | 2006-09-06 |
| 1982250411 | Michael Bradley | Peer Specialist | 125 S Main Cross St, Louisa, KY 41230-1065 | 2019-08-12 |
| 1841758604 | Michael Bradley | Counselor | 815 Grandview Rd, Oil City, PA 16301-2077 | 2019-03-11 |
| 1386091346 | Michael Bradley | Licensed Psychiatric Technician | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2016-05-19 |
| 1770954166 | Michael Bradley | Behavioral Analyst | 1469 Johnston Willis Dr, North Chesterfield, VA 23235-4730 | 2015-10-12 |
| 1922270644 | Michael Joseph Bradley | Internal Medicine | 7101 Jahnke Rd, Hca, Richmond, VA 23225 | 2008-04-02 |
| 1972771293 | Michael Douglas Bradley | Emergency Medical Technician, Intermediate | Bld 301 Andrews Ave, Lyster Army Health Clinic, Ft. Rucker, AL 36362 | 2008-02-20 |
| 1174729529 | Michael Durante Bradley | Pharmacist | 80 Jesse Hill Jr Dr Se, Pharmacy Administration, Atlanta, GA 30303-3031 | 2007-06-22 |
| Street Address |
404 SHOPPERS DR |
| City | WINCHESTER |
| State | KY |
| Zip Code | 40391-1378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326045360 | Jeremy Sean Kruger | Physical Therapist | 404 Shoppers Dr, Winchester, KY 40391-1378 | 2005-07-06 |
| 1962963371 | Kentucky Orthopedic Rehabilitation, LLC | Clinic/Center | 404 Shoppers Dr, Winchester, KY 40391-1378 | 2019-03-28 |
| 1083185938 | Kentucky Orthopaedics & Spine Pllc | Physician Assistant | 404 Shoppers Dr, Winchester, KY 40391-1378 | 2018-12-17 |
| 1548706484 | Amy Lee Blair | Occupational Therapist | 404 Shoppers Dr, Winchester, KY 40391-1378 | 2017-01-17 |
| 1881959666 | Michael R. Heilig, Md, Pllc | Physical Therapist | 404 Shoppers Dr, Winchester, KY 40391-1378 | 2012-07-09 |
| 1811257561 | David Anthony Hamilton Jr. | Orthopaedic Surgery | 404 Shoppers Dr, Winchester, KY 40391 | 2012-05-29 |
| 1023345584 | Brandon H Embry | Physician Assistant | 404 Shoppers Dr, Winchester, KY 40391-1378 | 2009-11-04 |
| 1790915239 | David Michael Waespe | Orthopaedic Surgery | 404 Shoppers Dr, Winchester, KY 40391 | 2009-07-17 |
| 1750532867 | Sarah Dawn Ervin | Physician Assistant | 404 Shoppers Dr, Winchester, KY 40391-1378 | 2008-10-07 |
| 1962592972 | Jason E Delong | Physician Assistant | 404 Shoppers Dr, Winchester, KY 40391-1378 | 2006-10-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255838710 | Sharrock Strength and Rehab LLC | Clinic/Center | 1932 Bypass Road, Winchester, KY 40391 | 2018-04-11 |
| 1316264385 | Yvonne Marie Pendleton | Massage Therapist | 126 Professional Ave., Winchester, KY 40391 | 2010-04-29 |
| 1346478310 | Mack Anderson Kidd IIi | Registered Nurse | 105 Lindberg Rd., Winchester, KY 40391 | 2009-06-29 |
| 1043487572 | Rankin Douglas Skinner | Dentist | 726 Boonesboro Plaza, Winchester, KY 40391 | 2008-05-14 |
| 1427233592 | Clark County Health Department | Public Health or Welfare | 244 E. Broadway, Shearer Elementary School, Winchester, KY 40391 | 2008-01-08 |
| 1437334505 | Clark County Health Department | Public Health or Welfare | 250 N. Main St., Fannie Bush Elementary, Winchester, KY 40391 | 2008-01-08 |
| 1598886251 | Winchester Open Mri | Radiology | 475 Shoppers Village Drive, Winchester, KY 40391 | 2007-04-02 |
| 1265509285 | James Warren Rice | Orthopaedic Surgery | 400 Shoppers Dr, Winchester, KY 40391 | 2006-11-29 |
| 1932279262 | J Todd Scobee Dmd Psc | Clinic/Center | 1216 West Lexington Ave, Winchester, KY 40391 | 2006-11-08 |
| 1396823936 | Commonwealth Urology, Psc | Urology | 68 East Elkin Street, Stanton, KY 40391 | 2006-11-01 |
| Find all providers in zip 40391 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001529 | Careteam, LLC | Physician Assistant | 1330 Amherst St Ste E, Winchester, VA 22601-3054 | 2020-10-23 |
| 1467017137 | Megan Catherine Kish | Physician Assistant | 111 Cahille Dr, Winchester, VA 22602-6797 | 2019-05-07 |
| 1518430628 | Sean Michael Nadalin | Physician Assistant | 921 Orchard Hill Dr, Winchester, VA 22601-2771 | 2019-01-10 |
| 1417457193 | Brianna Renee Rosskamp | Physician Assistant | 607 E Jubal Early Dr Apt 1, Winchester, VA 22601-5178 | 2018-02-19 |
| 1770038739 | Rupal Patel | Physician Assistant | 207 Gateway Dr, Winchester, VA 22603-5835 | 2016-08-19 |
| 1932497419 | Angela Lynn Ettinger | Physician Assistant | 190 Campus Blvd, Ste. 300, Winchester, VA 22601 | 2011-07-18 |
| 1508049354 | William E Dalton | Physician Assistant | 106 Launchris Dr, Winchester, VA 22602-6610 | 2007-12-14 |
| 1639274921 | Melissa Lilly | Physician Assistant | 1870 Amherst Suite 2b, Winchester, VA 22601 | 2006-09-13 |
| 1508874033 | Alyson P Humphreys | Physician Assistant | 128 Medical Circle, Winchester, VA 22601 | 2006-08-03 |
| 1144278219 | Rachel Ann Carlson | Physician Assistant | 160 Merchant St Ste 200, Winchester, VA 22603-4772 | 2006-05-04 |
| Find all providers in WINCHESTER | ||||
| City | WINCHESTER |
| Zip Code | 40391 |
Please comment or provide details below to improve the information on MICHAEL SHANE BRADLEY.
| 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.