MS. MOLLY JOE BRADSHAW (NPI# 1720115421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720115421 |
| Entity Type | Individual |
| Full Name | MS. MOLLY JOE BRADSHAW |
| Credential | ARNP |
| Practice Address |
197 Will Walker Road Columbia KY 42728 |
| Mailing Address |
Po Box 1080 Burkesville KY 42717-1080 |
| Practice Telephone | 2703849981 |
| Practice Fax Number | 2703849989 |
| Mailing Telephone | 2708586655 |
| Mailing Fax Number | 2708584027 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2018-01-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3005094 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
3005094 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | APRN LICENSE | 3005094 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 43 Yawpo Ave, Oakland, NJ 074362714 | 2013370066 |
| Street Address |
197 WILL WALKER ROAD |
| City | COLUMBIA |
| State | KY |
| Zip Code | 42728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073029047 | Cumberland Family Medical Center, Inc | Clinic/Center | 197 Will Walker Road, Columbia, KY 42728 | 2017-12-28 |
| 1265739825 | Jennifer Overstreet | Nurse Practitioner | 197 Will Walker Road, Columbia, KY 42728-9999 | 2011-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598234114 | Spectrum Care Academy Bluegrass 2 | Psychiatric Residential Treatment Facility | 1175 Cane Valley Rd., Columbia, KY 42728 | 2018-11-14 |
| 1588176812 | Yuichi Kitagawa | Family Medicine | 803 Burksville St, Columbia, KY 42728 | 2017-10-26 |
| 1265983118 | Samantha Giles | Occupational Therapist | 700 Coy Trce, Columbia, KY 42728 | 2016-10-16 |
| 1164804720 | Cumberland Family Medical Center, Inc. | Clinic/Center | 158 Colonel Casey Drive, Columbia, KY 42728 | 2015-06-19 |
| 1164812509 | Eric Henderson Coomer | Registered Nurse | 85 Downey Drive, Columbia, KY 42728 | 2015-01-23 |
| 1154742518 | Mckinsey C Matney | Speech-Language Pathologist | 638 Huntington Way, Columbia, KY 42728 | 2014-01-02 |
| 1619309861 | Lake Cumberland District Health Department | Public Health or Welfare | 158 Col Casey Drive, Columbia, KY 42728 | 2013-07-30 |
| 1184872475 | Wal-mart Stores, Inc. | Eyewear Supplier (Equipment, not the service) | 2988 Burkesville Rd., Columbia, KY 42728 | 2008-08-29 |
| 1346412301 | Adair County Hospital District | Home Health | 904-b Westlake Drive, Columbia, KY 42728 | 2008-03-31 |
| 1922207513 | Columbia Medical Equipment, Inc. | Durable Medical Equipment & Medical Supplies | 937 Campbellsville Road, Columbia, KY 42728 | 2007-07-13 |
| Find all providers in zip 42728 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114526266 | Leslie Desha | Nurse Practitioner | 1109 Pheasant Run, Columbia, MO 65201-6253 | 2020-10-20 |
| 1407454101 | Jason D Jones | Nurse Practitioner | 213 Austell Dr, Columbia, TN 38401-5531 | 2020-10-14 |
| 1316544315 | Rezvaneh Goodarzi | Nurse Practitioner | 8830 Tamar Dr Apt 301, Columbia, MD 21045-2962 | 2020-10-03 |
| 1316559255 | Lauren Olivia Lenauer | Nurse Practitioner | 1600 E Broadway # 300, Columbia, MO 65201-5844 | 2020-08-21 |
| 1285246272 | Lourdes Claire De Las Alas | Nurse Practitioner | 6005 Shepherd Sq, Columbia, MD 21044-3114 | 2020-08-20 |
| 1619587540 | Josey Abraham | Nurse Practitioner | 305 Aiken Hunt Cir, Columbia, SC 29223-8407 | 2020-08-05 |
| 1588274765 | Tomeka Nichole Jackson | Nurse Practitioner | 6156 Saint Andrews Rd Ste 208, Columbia, SC 29212-3147 | 2020-08-03 |
| 1528696762 | Mark Edward Merkel | Nurse Practitioner | 1040 N James M Campbell Blvd, Columbia, TN 38401-2756 | 2020-04-01 |
| 1306489265 | Andrew Leitch | Nurse Practitioner | 313 N Trenholm Rd, Columbia, SC 29206-3207 | 2019-10-23 |
| 1760033476 | Emily Smith | Nurse Practitioner | 157 Chinquapin Cir, Columbia, SC 29212-2902 | 2019-09-24 |
| Find all providers in COLUMBIA | ||||
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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.