Shikota Bridgemon

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN61263932 Issued in WA

Practice address

5007 W Augusta Blvd
Chicago, IL 60651-4471

Phone

(313) 998-5527

NPI assigned

Jul 19, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Seryne Collective LLC

  • Developmentally Disabled Services Day Training Agency
  • Chicago, IL
  • NPI 1396637666
  NPD Authorized official

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

{
    "created_epoch": "1752883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752883200000",
    "number": "1023900396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10720 5TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5007 W AUGUSTA BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606514471",
            "telephone_number": "313-998-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGEMON",
        "first_name": "SHIKOTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-19",
        "last_updated": "2025-07-19",
        "certification_date": "2025-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "WA",
            "license": "RN61263932",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61263932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brickyard Orthodontics
• Bridge to Connection
• Yolanda Bridgeforth
• Mary Catherine Bridgeland, LPC
• Madeline Bridgeman, PT, DPT
• Bridgepoint Psychology Center Inc.
• Bridgeport Dental Smiles LLC
• Bridgeport Dental Specialists LLC
• Bridgeport Dental Specialists, LLC
• Bridgeport Eye Care, LLC

• Registered Nurse in Chicago, IL
• Providers in Chicago, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2025; 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.