Kenneth Bradshaw, DPM is a medicare enrolled "Podiatrist" provider in Clinton, Missouri. His current practice location is
1602 N 2nd St, Clinton, Missouri. You can reach out to his office (for appointments etc.) via phone at
(660) 885-8171.
Kenneth Bradshaw is licensed to practice in Missouri (license number 000385) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1134197924.
Healthcare Provider's Profile
| Full Name | Kenneth Bradshaw |
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| Gender | Male |
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| Speciality | Podiatrist |
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| Location | 1602 N 2nd St, Clinton, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1134197924
- Provider Enumeration Date: 03/09/2006
- Last Update Date: 12/29/2009
Medicare PECOS Information:
- PECOS PAC ID: 3375531940
- Enrollment ID: I20040503001308
Medical Identifiers
Medical identifiers for Kenneth Bradshaw such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1134197924 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213E00000X | Podiatrist | 000385 (Missouri) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kenneth Bradshaw allows following entities to bill medicare on his behalf.
| Provider Name | Golden Valley Memorial Hospital District |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1003873266
PECOS PAC ID: 4688561814
Enrollment ID: O20040407001299 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth Bradshaw is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kenneth Bradshaw, DPM
1602 N 2nd St,
Clinton, MO 64735-1192
Ph: (660) 885-8171 | Kenneth Bradshaw, DPM
1602 N 2nd St,
Clinton, MO 64735-1192
Ph: (660) 885-8171 |
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