Bridgepark Operations, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BRIDGEPARK OPERATIONS, LLC

Practice address

4017 Liberty Heights Ave
Baltimore, MD 21207-7545

Phone

(410) 542-5306

NPI assigned

Oct 11, 2018

Organization subpart

No

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

Authorized official

Name

Sam Stern

Title

Cfo

Phone

(718) 567-0400

Specialties & licenses 1

Addresses

Other names 1

• Autumn Lake Healthcare at Bridgepark Doing business as

Tax ID family

Autumn Lake Healthcare at Bridgepark2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Bridgepark Operations, LLC

  • Skilled Nursing Facility
  • Baltimore, MD
  • NPI 1831696509
  NPD tax ID

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1154896694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14C 53RD ST STE 220",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322644",
            "telephone_number": "718-567-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4017 LIBERTY HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212077545",
            "telephone_number": "410-542-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEPARK OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "718-567-0400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Lake Healthcare at Bridgepark",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bridge to Life LLC
• Sanaai Bridgeford
• Erika Bridgeforth
• Taylor Bridgeforth
• Anna Elizabeth Bridgeman
• Bridgepark Operations, LLC
• Cheryl Dianna Bridges, DNP, MS, MBA, ACNP
• Dana Denise Bridges, MS, CRNP-BC
• Marie Therese Bridges, MS, RDN, CEDS
• Savana Bridges

• Skilled Nursing Facility in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.