Individual provider Active NPI

Bridgett Fisk, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1548889116
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP145654 Issued in TX
Practice address
3560 Delaware St Ste 207
Beaumont, TX 77706-3059
Phone
(409) 291-7622
Fax
(409) 292-2100
NPI assigned
Apr 13, 2020
Last updated
Feb 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP145654 TX Primary

Addresses

Primary practice location

3560 Delaware St Ste 207
Beaumont, TX 77706-3059

Mailing address

3560 Delaware St
Ste 207
Beaumont, TX 77706-3059
Phone (409) 291-7622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200506000999 TX Practitioner - Nurse Practitioner 6709217862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jason Mensah DO PAGroup PAC ID 8426331141, 5 clinicians

Practice addresses (Care Compare)

3560 Delaware St
Suite 207
Beaumont, TX 77706-3059
Phone (409) 291-7622

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP145654TXMDPsychiatric/Mental Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: beaumontbridgettfisk@160265.advancedmd-direct.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1548889116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 DELAWARE ST",
            "address_2": "STE 207",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063059",
            "telephone_number": "409-291-7622",
            "fax_number": "409-292-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 DELAWARE ST STE 207",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063059",
            "telephone_number": "409-291-7622",
            "fax_number": "409-292-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISK",
        "first_name": "BRIDGETT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP145654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.