Bridget Denise Bethea, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP5151 Issued in AZ

Practice address

2840 N Dysart Rd
Goodyear, AZ 85395-2338

Phone

(623) 536-5310

Fax

(401) 652-9787

NPI assigned

Jul 31, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

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.

• Arizona CVS Stores LLC

  • Pharmacy
  • Goodyear, AZ
  • NPI 1669576559
  NPD
• Women'S Care Arizona, LLC

  • Obstetrics Physician
  • Phoenix, AZ
  • NPI 1942977624
  NPD
• The Arizona Partnership for Immunization

  • Public Health or Welfare Agency
  • Phoenix, AZ
  • NPI 1942532189
  NPD (past)

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1376733758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748860",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30374",
            "telephone_number": "623-433-0106",
            "fax_number": "623-535-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 N DYSART RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952338",
            "telephone_number": "623-536-5310",
            "fax_number": "401-652-9787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10815 W McDowell Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Avondale",
            "state": "AZ",
            "postal_code": "853925016",
            "country_code": "US",
            "telephone_number": "623-433-0106",
            "fax_number": "623-535-0741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BETHEA",
        "first_name": "BRIDGET",
        "middle_name": "DENISE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024169131",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "335325-1",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN221907",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP5151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "873862",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Toni L Bennalley, L.AC.
• Bradley Paul Bennin, D.O.
• Haley B Berg, PHARMD
• Jared J Berkowitz, M.D.
• Juan Berumen
• Paige Elizabeth Bethke, RDN
• Beyond Expectations Speech Therapy LLC
• Bfgy Medical Group LLC
• Sharan Kaur Bhambrah, FACILITY MANAGER RN
• Supriya Bhardwaj, MD

• Family Nurse Practitioner in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.