Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Johnnie Mack Bradshaw, PA-C

Individual provider Physician Assistant · NPI 1740386267

Mr. Johnnie Mack Bradshaw, PA-C is a Physician Assistant in Charlotte, North Carolina. Licensed in North Carolina. Registered with an NPI since 2006.

Licensed in
NC
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2001 Randolph Rd
Charlotte, NC 28207-1215
Phone: (704) 323-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 100701 (NC)

Record details

NPI number1740386267
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 15, 2006
Last updated in NPPESFebruary 28, 2014

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