Individual provider Active NPI

Bridgette C Dyson, FNP-BC

  • Family Nurse Practitioner
  • Berkley, MI
National Provider Identifier
1306120928
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704210331 Issued in MI
Practice address
1695 12 Mile Rd Ste 220
Berkley, MI 48072-2100
Phone
(248) 582-1480
NPI assigned
Sep 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704210331 MI
Family Nurse Practitioner 363LF0000X 4704210331 MI Primary

Addresses

Primary practice location

1695 12 Mile Rd Ste 220
Berkley, MI 48072-2100

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1865

Other practice location 1

3581 W 13 Mile Rd Ste Bcc
Royal Oak, MI 48073-6710
Phone (248) 551-3300

Other practice location 2

44199 Dequindre Rd Ste 612
Troy, MI 48085-1128
Phone (248) 964-5170

Other names 1

  • Ms. Bridgette C. Waldrup Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bdyson4410235@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20111107000653 MI Practitioner - Nurse Practitioner 5799958716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

28100 Grand River Ave
Farmington Hills, MI 48336-5970

44199 Dequindre Rd
Troy, MI 48085-1128

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.37 of 100Reported as group
Quality
66.73
Promoting interoperability
100
Improvement activities
40
Cost
70.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704210331MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group- Specialty Services CurrentSince Jul 25, 2022 Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

3581 W 13 Mile Rd
Ste Bcc
Royal Oak, MI 48073
Phone (248) 551-3300

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

44199 Dequindre Rd
Ste 612
Troy, MI 48085
Phone (248) 964-5170

Interoperability endpoints

  • Direct secure messaging: bdyson1232184@epic00.shdirect.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1317340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1306120928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1865",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 12 MILE RD STE 220",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480722100",
            "telephone_number": "248-582-1480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3581 W 13 Mile Rd Ste Bcc",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736710",
            "country_code": "US",
            "telephone_number": "248-551-3300",
            "fax_number": "248-551-3370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44199 Dequindre Rd Ste 612",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851128",
            "country_code": "US",
            "telephone_number": "248-964-5170",
            "fax_number": "248-964-5175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYSON",
        "first_name": "BRIDGETTE",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-30",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704210331",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704210331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdyson4410235@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44199 Dequindre Rd Ste 612",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRIDGETTE",
            "last_name": "WALDRUP",
            "middle_name": "C.",
            "prefix": "MS.",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Berkley, MI

Sources for this page

Verify at the official NPI Registry.