Organization Active NPI

Wellness Bridge Group

  • Health Maintenance Organization
  • Spanish Fork, UT
National Provider Identifier
1376136457
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
WELLNESS BRIDGE GROUP
Practice address
994 Expressway LN
Spanish Fork, UT 84660-1384
Phone
(385) 685-8566
NPI assigned
Feb 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Authorized official

Name
Paul Jarred Freeman, BA (HONS) BUSINESS
Title
Director
Phone
(385) 685-8566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

994 Expressway LN
Spanish Fork, UT 84660-1384

Mailing address

752 S Willow LN
Mapleton, UT 84664-5618
Phone (385) 685-8566

National Provider Directory

National Provider Directory

Locations

994 Expressway Ln
Spanish Fork, UT 84660
Phone (385) 685-8566

NPI Registry JSON

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1376136457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 S WILLOW LN",
            "city": "MAPLETON",
            "state": "UT",
            "postal_code": "846645618",
            "telephone_number": "385-685-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "994 EXPRESSWAY LN",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601384",
            "telephone_number": "385-685-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS BRIDGE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "JARRED",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "385-685-8566",
        "authorized_official_credential": "BA (HONS) BUSINESS"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spanish Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.