Bridgewood Nursing and Rehab Center LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

BRIDGEWOOD NURSING AND REHAB CENTER LLC

Practice address

125 Byrd Ave
Neenah, WI 54956-4015

Phone

(920) 725-2714

NPI assigned

Nov 19, 2012

Organization subpart

Yes

Parent organization

EDURO HEALTHCAREAs reported in NPPES

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

Authorized official

Name

Catherine Dyer

Title

Human Resources

Phone

(801) 601-1450

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1497099147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6340 S 3000 E",
            "address_2": "SUITE 330",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841213540",
            "telephone_number": "801-601-1450",
            "fax_number": "801-996-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BYRD AVE",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564015",
            "telephone_number": "920-725-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWOOD NURSING AND REHAB CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EDURO HEALTHCARE",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "DYER",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "HUMAN RESOURCES",
        "authorized_official_telephone_number": "801-601-1450"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Neenah, WI
• Point of Service in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.