Bridge Centers LLC

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

Legal business name

BRIDGE CENTERS LLC

Practice address

4310 N Woodgate LN
Eagan, MN 55122-2277

Phone

(952) 492-1031

NPI assigned

Jun 17, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Abdifatah Abdullahi Mohamed

Title

Director

Phone

(952) 492-1031

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1063255024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 N WOODGATE LN",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222277",
            "telephone_number": "952-492-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 N WOODGATE LN",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222277",
            "telephone_number": "952-492-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "ABDIFATAH",
        "authorized_official_middle_name": "ABDULLAHI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "952-492-1031",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Brengman, DDS
• Brent L Florine, DDS, PLLC
• Charlotte Brenteson, PT
• Mary C Bretzman, MD
• Paul William Breyen, PT
• Bright Spectrum Center
• Logan Brinn, PHARMD
• Jamie Briski
• Karen Brisky
• Lance Gary Brisky, D.C.

• All providers in Eagan, MN
• Developmental - Behavioral Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.