NPIMap

Organization Active NPI

Bridgeway Inc

  • Mental Health Counselor
  • Galesburg, IL
National Provider Identifier
1629319389
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
149015718 Issued in IL
Legal business name
BRIDGEWAY INC
Practice address
2323 Windish Dr
Galesburg, IL 61401-9780
Phone
(309) 344-4250
Fax
(309) 344-4368
NPI assigned
Mar 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Authorized official

Name
Kristy Lee Rushing
Title
Benefit Specialist
Phone
(309) 344-4250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 149015718 IL Primary

Addresses

Primary practice location

2323 Windish Dr
Galesburg, IL 61401-9780

Mailing address

2323 Windish Dr
Galesburg, IL 61401-9780
Phone (309) 344-4250

National Provider Directory

National Provider Directory
Tax ID family
Julio R Lozano MD15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

2323 Windish Dr
Galesburg, IL 61401
Phone (309) 344-2323

NPI Registry JSON

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362528000000",
    "number": "1629319389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 WINDISH DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614019780",
            "telephone_number": "309-344-4250",
            "fax_number": "309-344-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 WINDISH DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614019780",
            "telephone_number": "309-344-4250",
            "fax_number": "309-344-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWAY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-03-06",
        "status": "A",
        "authorized_official_last_name": "RUSHING",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "BENEFIT SPECIALIST",
        "authorized_official_telephone_number": "309-344-4250"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149015718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.