Individual provider Active NPI

Romon Bridges

  • Respite Care
  • Phoenix, AZ
National Provider Identifier
1104669100
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
Practice address
20025 N 20TH St Unit 138
Phoenix, AZ 85024-1220
Phone
(209) 292-9059
NPI assigned
Jun 17, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care Camp 385HR2050X
Child Mental Illness Respite Care 385HR2055X
Respite Care 385H00000X Primary

Addresses

Primary practice location

20025 N 20TH St Unit 138
Phoenix, AZ 85024-1220

Mailing address

20025 N 20TH St Unit 138
Phoenix, AZ 85024-1220

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Living LLC Respite Care CurrentSince Aug 4, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1104669100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20025 N 20TH ST UNIT 138",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850241220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20025 N 20TH ST UNIT 138",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850241220",
            "telephone_number": "209-292-9059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "ROMON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2050X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care Camp",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.