Active NPI
Christen Bridgwater, BCPP
- Prevention Professional
- Naperville, IL
National Provider Identifier
1013436765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- 2150059
- Practice address
- 312 Apple River Dr
Naperville, IL 60565-6324 - Phone
- (909) 680-5102
- NPI assigned
- Sep 13, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | 2150059 | IL | Primary |
Addresses
Primary practice location
312 Apple River Dr
Naperville, IL 60565-6324
Mailing address
312 Apple River Dr
Naperville, IL 60565-6324
Phone (909) 680-5102
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2150059 | IL | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1013436765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 APPLE RIVER DR",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605656324",
"telephone_number": "909-680-5102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 APPLE RIVER DR",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605656324",
"telephone_number": "909-680-5102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIDGWATER",
"first_name": "CHRISTEN",
"credential": "BCPP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-13",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "IL",
"license": "2150059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.