Active NPI
Bridgett Holt
- Primary Care Nurse Practitioner
- South Bend, IN
National Provider Identifier
1184535981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 28229482A
- Practice address
- 4121 Kennedy Dr
South Bend, IN 46614-2819 - Phone
- (574) 514-9144
- NPI assigned
- Sep 14, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 28229482A | IN | Primary |
Addresses
Primary practice location
4121 Kennedy Dr
South Bend, IN 46614-2819
Mailing address
4121 Kennedy Dr
South Bend, IN 46614-2819
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789344000000",
"number": "1184535981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4121 KENNEDY DR",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466142819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4121 KENNEDY DR",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466142819",
"telephone_number": "574-514-9144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLT",
"first_name": "BRIDGETT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-09-14",
"last_updated": "2026-09-14",
"certification_date": "2026-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "IN",
"license": "28229482A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.