NPIMap

Organization Active NPI

Bridge ABA

  • Behavior Analyst
  • Pocola, OK
National Provider Identifier
1447965280
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BRIDGE ABA
Practice address
900 Ellis Loop
Pocola, OK 74902-2428
Phone
(479) 650-3802
NPI assigned
Jan 17, 2023
Last updated
Jan 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

Name
William Keith Montgomery, MS BCBANPI 1184382731
Title
Owner/Bcba
Phone
(479) 650-3802

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary
Behavior Technician 106S00000X NU

Addresses

Primary practice location

900 Ellis Loop
Pocola, OK 74902-2428

Mailing address

6502 Hilltop Rd
Van Buren, AR 72956-7604
Phone (479) 650-3802

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1447965280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6502 HILLTOP RD",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729567604",
            "telephone_number": "479-650-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 ELLIS LOOP",
            "city": "POCOLA",
            "state": "OK",
            "postal_code": "749022428",
            "telephone_number": "479-650-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE ABA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OWNER/BCBA",
        "authorized_official_telephone_number": "479-650-3802",
        "authorized_official_credential": "MS BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocola, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.