Active NPI
Terrea Gina Bridges
- Behavior Technician
- Lawrenceville, GA
National Provider Identifier
1629614037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-19-91496
- Practice address
- 2387 Huntcrest Rd
Lawrenceville, GA 30043 - Phone
- (678) 710-2324
- NPI assigned
- Nov 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-19-91496 | GA | Primary |
Addresses
Primary practice location
2387 Huntcrest Rd
Lawrenceville, GA 30043
Mailing address
2908 Heritage Oaks Cir
Dacula, GA 30019-7083
Phone (678) 499-6278
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-19-91496 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591228800000",
"number": "1629614037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2908 HERITAGE OAKS CIR",
"city": "DACULA",
"state": "GA",
"postal_code": "300197083",
"telephone_number": "678-499-6278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2387 HUNTCREST RD",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "30043",
"telephone_number": "678-710-2324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIDGES",
"first_name": "TERREA",
"middle_name": "GINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-20",
"last_updated": "2020-06-04",
"certification_date": "2020-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-19-91496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.