NPIMap

Organization Active NPI

Bridgepoint Clinic

  • Psychiatry Physician
  • Smyrna, GA
National Provider Identifier
1396464483
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BRIDGEPOINT CLINIC
Practice address
4125 Atlanta Rd SE Ste 120
Smyrna, GA 30080-6526
Phone
(770) 858-5377
Fax
(770) 874-3310
NPI assigned
Aug 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Authorized official

Name
Arun Kantamneni, MDNPI 1962659391
Title
Owner
Phone
(770) 858-5377

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

4125 Atlanta Rd SE Ste 120
Smyrna, GA 30080-6526

Mailing address

4125 Atlanta Rd SE Ste 120
Smyrna, GA 30080-6526
Phone (770) 858-5377

Other names 1

  • BRIDGEPOINT Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2235384Bridgepoint Clinic LLC4125 Atlanta Road Suite 120, Smyrna, GA 30080Certificate of waiverSep 8, 2027

National Provider Directory

National Provider Directory

Locations

4125 Atlanta Rd SE
Ste 120
Smyrna, GA 30080
Phone (770) 858-5377

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1396464483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 ATLANTA RD SE STE 120",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806526",
            "telephone_number": "770-858-5377",
            "fax_number": "770-874-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 ATLANTA RD SE STE 120",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806526",
            "telephone_number": "770-858-5377",
            "fax_number": "770-874-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEPOINT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "KANTAMNENI",
        "authorized_official_first_name": "ARUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-858-5377",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRIDGEPOINT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.