Beacon Bridge - Wilmington LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BEACON BRIDGE - WILMINGTON LLC

Practice address

5425 Wrightsville Ave
Wilmington, NC 28403-6513

Phone

(833) 496-0445

Fax

(984) 208-5220

NPI assigned

Oct 29, 2024

Last updated

Dec 8, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alexander Peter YousifNPI 1649051624

Title

Ceo

Phone

(984) 282-6654

Specialties & licenses 1

Addresses

Other names 1

• Beacon Bridge of North Carolina Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alexander Peter Yousif, CPSS

  • Peer Specialist
  • Durham, NC
  • NPI 1649051624
  Authorized official Same address or phone

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

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733616000000",
    "number": "1376365486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 DUNSTAN AVE STE B",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072390",
            "telephone_number": "984-282-6654",
            "fax_number": "984-208-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 WRIGHTSVILLE AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036513",
            "telephone_number": "833-496-0445",
            "fax_number": "984-208-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON BRIDGE - WILMINGTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-12-08",
        "certification_date": "2024-12-08",
        "status": "A",
        "authorized_official_last_name": "YOUSIF",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "984-282-6654"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Bridge of North Carolina",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2024; 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.