Bridgette Michelle Noble, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

E17890 Issued in AR

Practice address

1110 SE 30TH St
Bentonville, AR 72712-4290

Phone

(479) 282-2966

NPI assigned

Mar 22, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Bridgette Michelle Noble Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Living Tree Pediatrics, PLLC

  • Pediatrics Physician
  • Bentonville, AR
  • NPI 1396102679
  NPD
• Oklahoma State University

  • Medical Specialty Clinic/Center
  • Tulsa, OK
  • NPI 1306882261

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1336725142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 MAPLEWOOD AVE",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727455007",
            "telephone_number": "817-773-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SE 30TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124290",
            "telephone_number": "479-282-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "BRIDGETTE",
        "middle_name": "MICHELLE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E17890",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIDGETTE",
            "last_name": "NOBLE",
            "middle_name": "MICHELLE",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Theresa R Nida
• Thomas Niemela, DC
• Nits End, LLC
• Courtney Elise Nixon, APRN
• No Limits Pediatric Therapies
• Jade Noble, QBHP
• Shannon Nolan, MHPP
• Alexandra Norris
• Sean Northrip, MHPP
• Northwest Arkansas Classical Academy

• Pediatrics Physician in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.