Bridget Renee Johnson

Primary specialty

ContractorTaxonomy code 171W00000X

License

AF670251586 Issued in MI

Practice address

20090 210TH Ave
Tustin, MI 49688-8210

Phone

(231) 829-5095

NPI assigned

Jan 2, 2012

Last updated

Jan 2, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1325462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325462400000",
    "number": "1578833919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20090 210TH AVE",
            "city": "TUSTIN",
            "state": "MI",
            "postal_code": "496888210",
            "telephone_number": "231-829-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20090 210TH AVE",
            "city": "TUSTIN",
            "state": "MI",
            "postal_code": "496888210",
            "telephone_number": "231-829-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRIDGET",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-02",
        "last_updated": "2012-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "MI",
            "license": "AF670251586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey Cooper
• Caitlin Deboard, LMSW
• Abigail Dawn Dennis
• Jonathan Andrew Dennis, DO
• Sheree L Engler, RN
• Abhishek Kelkar
• Mecosta County Medical Center (Spectrum Health Big Rapids Hospital Family Medicine Tustin)
• Holli Michelle Meier, MA, CCC-SLP
• Kelly Mitchell
• Ronald W Moesta, MSW

• Contractor in Tustin, MI
• Providers in Tustin, MI by specialty
• Contractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2012; 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.