NPIMap

Organization Active NPI

Key Bridge, Inc.

  • Community/Behavioral Health Agency
  • Key West, FL
National Provider Identifier
1306381215
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
IMH14005 Issued in FL
Legal business name
KEY BRIDGE, INC.
Practice address
1111 12TH St Ste 101
Key West, FL 33040-4084
Phone
(305) 783-3677
Fax
(305) 407-3395
NPI assigned
Dec 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Authorized official

Name
Michael Rogers, LMHCNPI 1760892038
Title
President
Phone
(305) 783-3677

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X IMH14005 FL Primary

Addresses

Primary practice location

1111 12TH St Ste 101
Key West, FL 33040-4084

Mailing address

1111 12TH St Ste 101
Key West, FL 33040-4084
Phone (305) 783-3677

Other practice location 1

8650 W Sample Rd
Coral Springs, FL 33065-4431
Phone (305) 783-3677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180504001001 FL Part B Supplier - Clinic/Group Practice 2769746452 Receives reassigned benefits from 7 practitioners
Practice locations: Coral Springs, FL; Key West, FL

National Provider Directory

National Provider Directory

Locations

1111 12th St
Ste 212
Key West, FL 33040
Phone (305) 296-2212

1111 12th St
Ste 101
Key West, FL 33040
Phone (305) 783-3677

Networks

  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • HealthSun Health Plans Network

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1483142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1306381215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 12TH ST STE 101",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330404084",
            "telephone_number": "305-783-3677",
            "fax_number": "305-407-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 12TH ST STE 101",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330404084",
            "telephone_number": "305-783-3677",
            "fax_number": "305-407-3395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8650 W Sample Rd",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330654431",
            "country_code": "US",
            "telephone_number": "305-783-3677",
            "fax_number": "305-407-3395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KEY BRIDGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-31",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-783-3677",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "IMH14005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Key West, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.