Bridge Support Coordination Services

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Legal business name

BRIDGE SUPPORT COORDINATION SERVICES

Practice address

5739 N 17TH St
Philadelphia, PA 19141-1714

Phone

(267) 815-4094

NPI assigned

Oct 4, 2018

Last updated

Oct 4, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Paden Kevin Hinds

Title

Owner

Phone

(267) 815-4094

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1558836676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5739 N 17TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191411714",
            "telephone_number": "267-815-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5739 N 17TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191411714",
            "telephone_number": "267-815-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE SUPPORT COORDINATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "HINDS",
        "authorized_official_first_name": "PADEN",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-815-4094",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Case Manager/Care Coordinator in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; 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.