NPIMap

Organization Active NPI

Brightbridge ABA New Mexico LLC

  • Behavior Analyst
  • Winston Salem, NC
National Provider Identifier
1508659459
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BRIGHTBRIDGE ABA NEW MEXICO LLC
Practice address
301 N Main St Ste 2434
Winston Salem, NC 27101-3885
Phone
(336) 510-7910
NPI assigned
May 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 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
(336) 245-9155

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

301 N Main St Ste 2434
Winston Salem, NC 27101-3885

Mailing address

743 Central Ave
Woodmere, NY 11598-2614
Phone (347) 268-4827

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1747958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1508659459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 CENTRAL AVE",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115982614",
            "telephone_number": "347-268-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N MAIN ST STE 2434",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013885",
            "telephone_number": "336-510-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTBRIDGE ABA NEW MEXICO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "JEGER",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-245-9155"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 May 23, 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.