Individual provider Active NPI

Bridgette Michelle Wiliams

  • Health & Wellness Coach
  • North Little Rock, AR
National Provider Identifier
1366191322
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
License
756973 Issued in CA
Practice address
704 Ellen Dr
North Little Rock, AR 72117-3549
Phone
(713) 480-0997
NPI assigned
Mar 18, 2022
Last updated
Mar 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X 756973 CA Primary

Addresses

Primary practice location

704 Ellen Dr
North Little Rock, AR 72117-3549

Mailing address

2513 McCain Blvd.
Suite 2 PO Box 212
North Little Rock, AR 72116-3549
Phone (501) 436-3715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
756973CAMDHealth & Wellness Coach

NPI Registry JSON

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1366191322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2513 MCCAIN BLVD.",
            "address_2": "SUITE 2 PO BOX 212",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721163549",
            "telephone_number": "501-436-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 ELLEN DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721173549",
            "telephone_number": "713-480-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILIAMS",
        "first_name": "BRIDGETTE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "CA",
            "license": "756973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.