NPIMap

Organization Active NPI

Brightbridge ABA North Carolina LLC

  • Behavior Analyst
  • Winston Salem, NC
National Provider Identifier
1396570701
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BRIGHTBRIDGE ABA NORTH CAROLINA LLC
Practice address
615 Saint George Square CT Ste 300
Winston Salem, NC 27103-1368
Phone
(347) 268-4827
NPI assigned
Sep 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Authorized official

Name
Leonard Jeger
Title
Ceo
Phone
(347) 268-4827

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

615 Saint George Square CT Ste 300
Winston Salem, NC 27103-1368

Mailing address

1000 Park Centre Blvd Ste 134
Miami, FL 33169-5373
Phone (305) 651-5762

National Provider Directory

National Provider Directory

Locations

301 N Main St
Ste 2434
Winston Salem, NC 27101
Phone (336) 510-7910

Practitioners & affiliated clinicians

Practitioners 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1396570701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 PARK CENTRE BLVD STE 134",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331695373",
            "telephone_number": "305-651-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SAINT GEORGE SQUARE CT STE 300",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031368",
            "telephone_number": "347-268-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTBRIDGE ABA NORTH CAROLINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-05",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "JEGER",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-268-4827"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.