Active NPI
Romon Bridges
- Respite Care
- Phoenix, AZ
National Provider Identifier
1104669100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Respite Care
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarity Living LLC | Respite Care | Current | 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.
-
- Respite Care
- Phoenix, AZ
- NPI 1801626064
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.