NPIMap

Organization Active NPI

FBTC Transitional Sub, LLC

Doing business as Bright Light

  • Community/Behavioral Health Agency
  • Matthews, NC
National Provider Identifier
1073387874
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FBTC TRANSITIONAL SUB, LLC
Doing business as
Bright Light
Practice address
1216 Mann Dr
Matthews, NC 28105-5512
Phone
(980) 262-3043
Fax
(980) 339-5617
NPI assigned
Nov 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Mary Patricia Rodenberg-Roberts
Title
VP & Sr. Asst General Counsel
Phone
(952) 836-2234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1216 Mann Dr
Matthews, NC 28105-5512

Mailing address

55 Tozer Rd
Beverly, MA 01915-5515
Phone (978) 969-2894

Other names 1

  • Bright Light Doing business as

National Provider Directory

National Provider Directory
Tax ID family
FBTC Transitional Sub LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

613 Towne Park Dr W
Ste 103
Rincon, GA 31326
Phone (912) 208-4776

440 Roper Mountain Rd
Greenville, SC 29615
Phone (251) 714-6746

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1073387874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 TOZER RD",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155515",
            "telephone_number": "978-969-2894",
            "fax_number": "978-969-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 MANN DR",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055512",
            "telephone_number": "980-262-3043",
            "fax_number": "980-339-5617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FBTC TRANSITIONAL SUB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "RODENBERG-ROBERTS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "VP & SR. ASST GENERAL COUNSEL",
        "authorized_official_telephone_number": "952-836-2234"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright Light",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bright Light",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Matthews, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.