Individual provider Active NPI

Bridget R Johnson, APN-CNP

  • Nurse Practitioner
  • Arlington Heights, IL
National Provider Identifier
1205455953
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209027911 Issued in IL
Practice address
880 W Central Rd Ste 7200
Arlington Heights, IL 60005-2382
Phone
(847) 618-4430
Fax
(847) 618-0786
NPI assigned
Apr 13, 2020
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209027911 IL Primary

Addresses

Primary practice location

880 W Central Rd Ste 7200
Arlington Heights, IL 60005-2382

Mailing address

880 W Central Rd Ste 7200
Arlington Heights, IL 60005-2382
Phone (847) 618-4430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240724001558 IL Practitioner - Nurse Practitioner 1456897644 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jul 12, 2024 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients

Locations

880 W Central Rd
Ste 7200
Arlington Hts, IL 60005
Phone (847) 259-2530

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1205455953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD STE 7200",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052382",
            "telephone_number": "847-618-4430",
            "fax_number": "847-618-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD STE 7200",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052382",
            "telephone_number": "847-618-4430",
            "fax_number": "847-618-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRIDGET",
        "middle_name": "R",
        "credential": "APN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209027911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.