NPIMap

Organization Active NPI

Bridgewater Speech & Hearing, Inc

  • Audiologist
  • Knoxville, TN
National Provider Identifier
1265560288
Registry record updated Feb 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
0275 Issued in TN
Legal business name
BRIDGEWATER SPEECH & HEARING, INC
Practice address
103 Suburban Rd
Suite 101D
Knoxville, TN 37923-5586
Phone
(865) 769-0283
NPI assigned
Mar 1, 2007
Last updated
Feb 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2018

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

Authorized official

Name
Dr. Sally Jo Baerman, AU.D.NPI 1417932211
Title
President
Phone
(865) 769-0283

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 0142 TN
Audiologist 231H00000X 0275 TN Primary
Speech-Language Pathologist 235Z00000X 1278 TN
Speech-Language Pathologist 235Z00000X 2154 TN

Addresses

Primary practice location

103 Suburban Rd
Suite 101D
Knoxville, TN 37923-5586

Mailing address

103 Suburban Rd
Suite 101D
Knoxville, TN 37923-5586
Phone (865) 769-0283

Other identifiers 1

IdentifierTypeStateIssuer
3730962MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050914000144 TN Part B Supplier - Clinic/Group Practice 1254364979 Receives reassigned benefits from 15 practitioners
Practice locations: Sevierville, TN; Knoxville, TN

National Provider Directory

National Provider Directory

Locations

117 S Charles G Seivers Blvd
Clinton, TN 37716
Phone (865) 269-4607

103 Suburban Rd
Ste 101D
Knoxville, TN 37923
Phone (865) 769-0283

103 Suburban Rd
Ste 103D
Knoxville, TN 37923

103 Suburban Rd
Ste D101
Knoxville, TN 37923
Phone (865) 769-0283

4005 Fountain Valley Dr
Ste 450
Knoxville, TN 37918
Phone (865) 377-4980

1240 Fox Meadows Blvd
Ste 5
Sevierville, TN 37862
Phone (865) 429-3888

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517961600000",
    "number": "1265560288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SUBURBAN RD",
            "address_2": "SUITE 101D",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379235586",
            "telephone_number": "865-769-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SUBURBAN RD",
            "address_2": "SUITE 101D",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379235586",
            "telephone_number": "865-769-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWATER SPEECH & HEARING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2018-02-07",
        "status": "A",
        "authorized_official_last_name": "BAERMAN",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-769-0283",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TN",
            "license": "0142",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TN",
            "license": "0275",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "1278",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "2154",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3730962",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.