Bridgemill Health Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26936 Issued in GA

Legal business name

BRIDGEMILL HEALTH GROUP LLC

Practice address

3542 Sixes Rd
Suite 100
Canton, GA 30114-9124

Phone

(678) 880-6118

Fax

(770) 720-1389

NPI assigned

Oct 29, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Scott Depol, DC

Title

Member/Manager

Phone

(678) 880-6118

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles D. Lecroy, D.C.

  • Chiropractor
  • Canton, GA
  • NPI 1184789042
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351468800000",
    "number": "1023362191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3542 SIXES RD",
            "address_2": "SUITE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301149124",
            "telephone_number": "678-880-6118",
            "fax_number": "770-720-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3542 SIXES RD",
            "address_2": "SUITE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301149124",
            "telephone_number": "678-880-6118",
            "fax_number": "770-720-1389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEMILL HEALTH GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-29",
        "last_updated": "2012-10-29",
        "status": "A",
        "authorized_official_last_name": "DEPOL",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "678-880-6118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO07708",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "26936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tequilla Brew-Chann
• Rachael Lynn Brewer, PT, DPT
• Bridgemill Family Healthcare, LLC
• Bridgemill Family Medical Associates, PC
• Bridgemill Family Pharmacy LLC
• Bridging the Gap Therapy LLC
• Laurie Briegel, D.C.
• Louis Briegel II, D.C.
• Kallie Law Brock, D.M.D.
• Amy Kemp Brockman

• Family Medicine Physician in Canton, GA
• Providers in Canton, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.