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

Individual provider Registered Dietitian · NPI 1013420207

Kennetra Bradshaw, RD is a Registered Dietitian OR Nutrition Professional in Covington, Kentucky. Qualified in 2017, 9 years ago. Practices with Summit Medical Group Inc, a 799-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Kentucky and Ohio.

Years since qualifying
9
Licensed in
KY, OH
In the registry since
2017
Specialties on file
2
What do these letters mean?
RD — Registered Dietitian
A credentialed nutrition professional.

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Practice location Address checks out

1500 James Simpson Jr Way
Covington, KY 41011-0801
Phone: (859) 655-8910
Fax: (859) 655-8911
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 35 Plymouth Ln, Elsmere, KY 41018-2717 — (859) 466-4754

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 261387 (KY)
Registered Dietitian Taxonomy 133V00000X · Licence LD08373 (OH)

Record details

NPI number1013420207
Entity typeIndividual (Type 1)
GenderFemale
Credentials RD
Sole proprietorNo
NPI enumeratedNovember 9, 2017
Last updated in NPPESFebruary 19, 2021
Certification dateFebruary 19, 2021
Mailing address35 Plymouth Ln, Elsmere, KY 41018-2717

Medicare enrollment

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

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Summit Medical Group Inc — 799 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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