MR. CHARLES JEREMY BRADSHAW (NPI# 1043477672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043477672 |
| Entity Type | Individual |
| Full Name | MR. CHARLES JEREMY BRADSHAW |
| Credential | MPAS PA-C |
| Practice Address |
1849 Old Donation Pkwy Virginia Beach VA 23454-3004 |
| Mailing Address |
1115 Boulders Pkwy Ste 200 North Chesterfield VA 23225-4067 |
| Practice Telephone | 7574228476 |
| Practice Fax Number | 7574258476 |
| Mailing Telephone | 8043279242 |
| Mailing Fax Number | 8043279812 |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2020-05-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0110003574 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 1081007 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TRICARE | VAD000 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881123321 | Charles Bradshaw | Physical Therapist | 118 Johnson Ave, Celina, OH 45822-1219 | 2017-06-08 |
| 1427595792 | Charles Everett Bradshaw | Pharmacist | 455 W Montana St, Pasadena, CA 91103-1327 | 2017-01-25 |
| 1538361456 | Charles Pedigo Bradshaw | Dentist | 220 Conway St, Suite 2, Frankfort, KY 40601-2748 | 2007-06-04 |
| 1104866714 | Charles Marshall Bradshaw | Specialist | 1521 Cooper St, Fort Worth, TX 76104-2711 | 2006-06-08 |
| 1780632851 | Charles B Bradshaw | Clinical Neuropsychologist | 750 E Adams St, Department of Neurology, Syracuse, NY 13210-2306 | 2006-05-04 |
| Street Address |
1849 OLD DONATION PKWY |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23454-3004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447258611 | Michele M Laneve | Physical Therapist | 1849 Old Donation Pkwy, Virginia Beach, VA 23454-3004 | 2005-07-12 |
| 1083267470 | Caitlin Lesko | Physical Therapist | 1849 Old Donation Pkwy, Virginia Beach, VA 23454-3004 | 2019-07-24 |
| 1164971545 | Orthovirgina, Inc. | Orthopaedic Surgery | 1849 Old Donation Pkwy, Virginia Beach, VA 23454-3004 | 2016-09-27 |
| 1871947481 | Elizabeth Ann Medway | Occupational Therapist | 1849 Old Donation Pkwy, Virginia Beach, VA 23454-3004 | 2016-04-20 |
| 1144644063 | Damian Bliek | Physical Therapist | 1849 Old Donation Pkwy, Virginia Beach, VA 23454-3004 | 2014-02-12 |
| 1548693484 | Andrew Lantz | Physical Therapist | 1849 Old Donation Pkwy, Virginia Beach, VA 23454-3004 | 2013-08-14 |
| 1194067280 | Wayne Alan Chen | Orthopaedic Surgery | 1849 Old Donation Pkwy, Virginia Beach, VA 23454 | 2013-03-27 |
| 1801134580 | Paul William Mitchell | Physical Therapist | 1849 Old Donation Pkwy, Virginia Beach, VA 23454 | 2013-01-30 |
| 1992864763 | Orthovirginia, Inc | Orthopaedic Surgery | 1849 Old Donation Pkwy, Virginia Beach, VA 23454-3004 | 2006-12-07 |
| 1730295981 | Elizabeth Belter | Physical Therapist | 1849 Old Donation Pkwy, Virginia Beach, VA 23454-3004 | 2006-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356994263 | Agape Consulting | Behavioral Analyst | 1216 Garth Court, Virginia Beach, VA 23454 | 2019-07-19 |
| 1831650266 | Amelia Jo Crutsinger | Physician Assistant | 1644 Kepler Bnd, Virginia Beach, VA 23454 | 2019-03-28 |
| 1538639158 | Bay Psychiatric II Inc | Counselor | 923 First Colonial Rd Suite 1821, Virginia Beach, VA 23454 | 2018-11-26 |
| 1487151759 | Akanksha Mohan | Student in an Organized Health Care Education/Training Program | 100 Mannng Drive, Chapel Hill, Nc 27514, Chapel Hill, NC 23454 | 2018-04-12 |
| 1275038580 | Food Lion, LLC | Durable Medical Equipment & Medical Supplies | 1615 General Booth Blvd, Virginia Beach, VA 23454 | 2018-03-28 |
| 1346783164 | Tracy Chasse | Occupational Therapy Assistant | 1628 Old Donation Parkway, Virginia Beach, VA 23454 | 2016-11-28 |
| 1982066627 | Jennifer Mitchell | Speech-Language Pathologist | 2101 Agecroft Rd., Virginia Beach, VA 23454 | 2016-03-22 |
| 1659730562 | Rebecca Houvener | Psychologist | 1120 First Colonial Rd Ste 202, Virginia Beach, VA 23454 | 2016-02-19 |
| 1932581741 | Monica Jane Bailey | Nurse Practitioner | 2110 N Great Neck Rd, Virginia Beach, VA 23454 | 2015-06-29 |
| 1376930073 | Ashley A Burkholder | Family Medicine | 1024 First Colonial Rd Ste 104, Virginia Beach, VA 23454 | 2015-04-20 |
| Find all providers in zip 23454 | ||||
| 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 |
|---|---|---|---|---|
| 1063047348 | Sara Minor Khadivi | Physician Assistant | 249 Cassady Ave, Virginia Beach, VA 23452-4248 | 2020-03-07 |
| 1659913283 | Jacqueline Alexander Oliver | Physician Assistant | 3198 Pacific Ave Ste 104, Virginia Beach, VA 23451-2949 | 2019-10-15 |
| 1831650266 | Amelia Jo Crutsinger | Physician Assistant | 1644 Kepler Bnd, Virginia Beach, VA 23454 | 2019-03-28 |
| 1972067908 | Taylor Elizabeth Rose | Physician Assistant | 445 Caren Dr, Virginia Beach, VA 23452-3511 | 2019-01-23 |
| 1427521533 | Stephanie Michelle Smith | Physician Assistant | 2025 Williams Farm Rd, Virginia Beach, VA 23457-1390 | 2019-01-10 |
| 1902374044 | Patricia Lynette Nash | Physician Assistant | 5589 Greenwich Rd Ste 175, Virginia Beach, VA 23462-6564 | 2018-11-07 |
| 1851884332 | Aaron Zadai | Physician Assistant | 4437 Blackwater Rd, Virginia Beach, VA 23457-1124 | 2018-06-11 |
| 1629561329 | Mary Katherine Pratt | Physician Assistant | 828 Healthy Way Ste 350, Virginia Beach, VA 23462 | 2018-06-07 |
| 1093196024 | Stephanie Zeiber | Physician Assistant | 3325 Woodsman Ln, Virginia Beach, VA 23452-5226 | 2015-06-16 |
| 1255733051 | Megan Christine Mcdevitt | Physician Assistant | 1168 First Colonial Rd Ste A, Virginia Beach, VA 23454 | 2014-09-23 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23454 |
Please comment or provide details below to improve the information on MR. CHARLES JEREMY BRADSHAW.
| 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.