Individual provider Active NPI

Raetta Dawn Bridges, FNP

  • Primary Care Nurse Practitioner
  • Mineral Wells, TX
National Provider Identifier
1245923622
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1126344 Issued in TX
Practice address
400 SW 25TH Ave
Mineral Wells, TX 76067-8246
Phone
(940) 325-7891
NPI assigned
May 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 856097 TX
Primary Care Nurse Practitioner 363LP2300X 1126344 TX Primary

Addresses

Primary practice location

400 SW 25TH Ave
Mineral Wells, TX 76067-8246

Mailing address

400 SW 25TH Ave
Mineral Wells, TX 76067-8246
Phone (940) 325-7891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230831003647 TX Practitioner - Nurse Practitioner 7214390657 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onpoint Health, PLLC 2 clinicians
Palo Pinto County Hospital District 40 clinicians

Practice addresses (Care Compare)

2307 E Hubbard St
Mineral Wells, TX 76067-5616
Phone (940) 274-6151

400 SW 25TH Ave
Mineral Wells, TX 76067-8246
Phone (940) 325-7891

Hospital & facility affiliations

  • Palo Pinto General Hospital Hospital, Mineral Wells, TX, CCN 450565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
856097TXMDFamily Nurse Practitioner
1126344TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palo Pinto County Hospital District Family Current Accepting new patients
Palo Pinto County Hospital District Current Accepting new patients
Palo Pinto County Hospital District Family CurrentSince Aug 5, 2023 Accepting new patients
Onpoint Health, PLLC CurrentSince Jan 27, 2026 Accepting new patients
Palo Pinto County Hospital District CurrentSince Aug 5, 2023 Accepting new patients
Palo Pinto County Hospital District Past Accepting new patients

Locations

202 SW 25th Ave
Ste 300
Mineral Wells, TX 76067
Phone (940) 328-6521

2307 E Hubbard St
Mineral Wells, TX 76067
Phone (940) 274-6151

400 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 325-7891

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1245923622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SW 25TH AVE",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760678246",
            "telephone_number": "940-325-7891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SW 25TH AVE",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760678246",
            "telephone_number": "940-325-7891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "RAETTA",
        "middle_name": "DAWN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "856097",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1126344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineral Wells, TX

Sources for this page

Verify at the official NPI Registry.