Individual provider Active NPI

Bridget Nadine McMullen, M.A. AUDIOLOGY

  • Audiologist
  • Lackland AFB, TX
National Provider Identifier
1568440923
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
51049 Issued in TX
Practice address
2200 Bergquist Dr
Lackland a F B, TX 78236-9908
Phone
(210) 292-7770
NPI assigned
Jan 5, 2006
Last updated
Mar 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 51049 TX Primary
Audiologist 231H00000X 2201001701 VA

Addresses

Primary practice location

2200 Bergquist Dr
Lackland a F B, TX 78236-9908

Mailing address

1718 Chippington Dr
San Antonio, TX 78253-5964

Other practice location 1

120 Kings Way
Williamsburg, VA 23185-2505
Phone (757) 345-2600

Other practice location 2

895 City Center Blvd Ste 152
Newport News, VA 23606-3080
Phone (757) 599-5505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190228002535 VA Practitioner - Qualified Audiologist 0345589701 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

895 City Ctr Blvd
Suite 152
Newport News, VA 23606-3080
Phone (757) 599-5505

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
51049TXMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince Jan 23, 2024 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services, Inc. CurrentSince Jan 23, 2024 Accepting new patients
Riverside Physician Services Inc Past Accepting new patients

Locations

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

895 City Center Blvd
Ste 152
Newport News, VA 23606
Phone (757) 599-5505

120 Kings Way
Ste 3500
Williamsburg, VA 23185
Phone (757) 220-6823

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1568440923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 CHIPPINGTON DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782535964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-292-7770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Kings Way",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231852505",
            "country_code": "US",
            "telephone_number": "757-345-2600",
            "fax_number": "757-253-1527",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "895 City Center Blvd Ste 152",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236063080",
            "country_code": "US",
            "telephone_number": "757-599-5505",
            "fax_number": "757-599-3618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "BRIDGET",
        "middle_name": "NADINE",
        "name_prefix": "Ms.",
        "credential": "M.A. AUDIOLOGY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "51049",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001701",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland AFB, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.