Jacqueline Mahony Bridge, DNP, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10727 Issued in CT

Practice address

25 Constitution Blvd S
Shelton, CT 06484-4351

Phone

(203) 924-7334

Fax

(203) 922-0004

NPI assigned

Apr 11, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Pediatric Care Associates of Connecticut

  • Pediatric Adolescent Medicine Physician
  • Shelton, CT
  • NPI 1396867958
  NPD (past)

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1356083380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CONSTITUTION BLVD S",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844351",
            "telephone_number": "203-924-7334",
            "fax_number": "203-922-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CONSTITUTION BLVD S",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844351",
            "telephone_number": "203-924-7334",
            "fax_number": "203-922-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGE",
        "first_name": "JACQUELINE",
        "middle_name": "MAHONY",
        "credential": "DNP, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "10727",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "135754",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chantal Andria Boyd
• Malaika M Boyer-Seme, MS, LPCA
• Michael Bozarth, PT, DPT
• Lisa Louise Brailey, M.D.
• Kevin Breton
• Bridgeport Radiological Associates LLC
• Brightpath Wellness PC
• Brightview Shelton LLC
• Rebecca Anne Brower, LMSW
• Henryriana Brown, MA

• Family Nurse Practitioner in Shelton, CT
• Providers in Shelton, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.