Individual provider Active NPI

Bridgette Stephanie Nelson, CRNP

  • Adult Health Nurse Practitioner
  • State College, PA
National Provider Identifier
1467735647
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP011533 Issued in PA
Practice address
3091 Enterprise Dr Ste 202
State College, PA 16801-3099
Phone
(610) 570-5639
NPI assigned
Sep 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP011533 PA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP021290 PA

Addresses

Primary practice location

3091 Enterprise Dr Ste 202
State College, PA 16801-3099

Mailing address

175 W Cohawkin Rd Ste C
Clarksboro, NJ 08020-1145
Phone (856) 423-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140221000099 PA Practitioner - Nurse Practitioner 4082844949 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Preventive Measures LLCGroup PAC ID 0345563615, 6 clinicians

Practice addresses (Care Compare)

3091 Enterprise Dr
Building D Suite 202
State College, PA 16801-3099
Phone (814) 954-7819

515 W Linden St
FL 4
Allentown, PA 18101-1426
Phone (484) 225-4323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP011533PAMDAdult Health Nurse Practitioner
SP021290PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bet-El Counseling Services, Inc CurrentSince Dec 16, 2020 Accepting new patients
B Nelson LLC Adult Health CurrentSince Aug 1, 2021 Accepting new patients
Preventive Measures, LLC CurrentSince Dec 1, 2022 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Nov 25, 2022 Accepting new patients
The Visiting Nurse Association of Greater Philadelphia PastSince May 16, 2009 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

175 W Cohawkin Rd
Ste C
Clarksboro, NJ 08020

515 W Linden St
Allentown, PA 18101
Phone (484) 225-4323

515 W Linden St
Fl 4
Allentown, PA 18101
Phone (484) 225-4323

243 E Brown St
East Stroudsburg, PA 18301
Phone (570) 421-3708

1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177

1169 Philipsburg Bigler Hwy
Philipsburg, PA 16866
Phone (814) 343-7373

3091 Enterprise Dr
Ste 202
State College, PA 16801
Phone (610) 570-5639

3091 Enterprise Dr
Bldg D
State College, PA 16801
Phone (814) 954-7819

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1467735647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 W COHAWKIN RD STE C",
            "city": "CLARKSBORO",
            "state": "NJ",
            "postal_code": "080201145",
            "telephone_number": "856-423-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3091 ENTERPRISE DR STE 202",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168013099",
            "telephone_number": "610-570-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BRIDGETTE",
        "middle_name": "STEPHANIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP011533",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP021290",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.