Bridge Clinics LLC

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

BRIDGE CLINICS LLC

Practice address

6357 Rockville Rd
Indianapolis, IN 46214-3920

Phone

(317) 757-2563

Fax

(317) 405-9970

NPI assigned

Jan 4, 2019

Last updated

Mar 8, 2021By 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

Latifat A. Oyekola, MDNPI 1376756684

Title

Owner

Phone

(317) 495-5173

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Tax ID family

Bridge Clinics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bridge Clinics Behavioral Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Indianapolis, IN
  • NPI 1326661836
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18899/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Latifat A. Oyekola, MD

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1376756684
  Medicare reassignment NPD Authorized official
• Samuel Dominic Kobba, N.P.

  • Family Nurse Practitioner
  • Elkhart, IN
  • NPI 1811211154
  Medicare reassignment NPD

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1568935278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6357 ROCKVILLE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462143920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6357 ROCKVILLE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462143920",
            "telephone_number": "317-757-2563",
            "fax_number": "317-405-9970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3702 E 10th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462012554",
            "country_code": "US",
            "telephone_number": "317-757-2563",
            "fax_number": "317-405-9970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRIDGE CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-04",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "OYEKOLA",
        "authorized_official_first_name": "LATIFAT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-495-5173",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harry Dwight Brickley Jr., M.D.
• Jocelyn Brickman
• Faith Brickner
• Bridge and Bloom Speech Therapy LLC
• Bridge Clinics Behavioral Health LLC
• Bridge of Hope, Inc (Bridge Of Hope Adult Day Center)
• Bridgecare ABA in LLC
• Bridges Coordination Services PC (Bridges Coordination Services)
• Bridges to Continuous Home Care LLC
• Amanda Bridges, LMT

• Addiction Medicine (Family Medicine) Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Addiction Medicine (Family Medicine) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.