Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Michael R Bradshaw, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1104311539

Dr. Michael R Bradshaw, MD is a Psychiatry in Jacksonville, North Carolina. Qualified in 2016, 10 years ago. Practices with Coastal Carolina Neuropsychiatric Center PA, a 28-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
10
Licensed in
NC
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

200 Tarpon Trl
Jacksonville, NC 28546-5287
Phone: (910) 938-1114
Fax: (910) 938-1118
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 2022-00948 (NC)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1104311539
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 27, 2018
Last updated in NPPESJune 2, 2022
Certification dateJune 2, 2022
Mailing address200 Tarpon Trl, Jacksonville, NC 28546-5287

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Coastal Carolina Neuropsychiatric Center Pa — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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